Paradoxical Skin Reaction to Certolizumab: Overlap of Pyoderma Gangrenosum and Psoriasis in a Young Woman Treated for Ankylosing Spondylitis - Case Report with Literature Review

    May 2020 in “ Dermatology and therapy
    Anna Gawdzik, Małgorzata Ponikowska, Alina Jankowska‐Konsur, Zdzisław Woźniak, Joanna Maj, Jacek C. Szepietowski
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    TLDR A young woman had a rare skin reaction to a medication for her joint disease, and a combination therapy improved her condition.
    A young woman with ankylosing spondylitis experienced a paradoxical skin reaction after 6 months of treatment with certolizumab, a biologic agent. This rare reaction manifested with symptoms of both pyoderma gangrenosum and palmoplantar pustular psoriasis, including alopecia and nail involvement. Despite discontinuing certolizumab, the condition did not improve, leading to the initiation of a combination therapy with secukinumab and methotrexate, which showed a promising outcome. This case highlights the need for further research into paradoxical skin reactions to biologic agents to better understand risk factors and develop personalized treatment strategies.
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