TNF-α Inhibitor-Induced Psoriasis and Psoriatic Alopecia in Adolescent with Ulcerative Colitis: Clinical Case

This clinical case study describes a 17-year-old patient with ulcerative colitis who developed paradoxical psoriasis (PP) and psoriatic alopecia after treatment with the TNF-α inhibitor infliximab. The patient experienced severe scalp lesions and hair loss, alongside worsening ulcerative colitis symptoms. After discontinuing infliximab, the patient was treated with ustekinumab, an IL-12/23 inhibitor, which led to the regression of skin rashes, restoration of hair growth, and remission of ulcerative colitis. The study highlights that PP is a rare complication of TNF-α inhibitors, particularly in patients with inflammatory bowel disease, and suggests that ustekinumab may be an effective first-line therapy for pediatric patients experiencing similar complications. This is the first reported case in Russian literature of successful management of PP and ulcerative colitis with ustekinumab in children.