January 2026 in “Forum Dermatologicum” This study systematically reviewed literature on paradoxical reactions during biologic treatments for psoriasis, identifying immune dysregulation mechanisms and diverse clinical manifestations, highlighting that mild cases often respond well to topical treatments, while severe cases may require switching to different IL-23 inhibitors.
12 citations
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May 2020 in “Dermatology and therapy” This case report describes a young woman with ankylosing spondylitis who developed a severe paradoxical skin reaction after six months on certolizumab, requiring treatment with secukinumab and methotrexate.
1 citations
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January 2026 in “International Journal of Dermatology” In this study, a case of dissecting cellulitis of the scalp was reported in a man after starting dupilumab therapy, highlighting potential immune pathways involved and the importance of recognizing such paradoxical inflammatory reactions to prevent irreversible alopecia.
September 2024 in “Cureus” This case report describes how changing treatment from adalimumab to guselkumab successfully controlled both pustulotic arthro-osteitis and paradoxical skin reactions in a patient with palmoplantar pustulosis.
2 citations
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February 2018 in “InTech eBooks” This article discusses adverse immune-mediated skin reactions associated with TNF-alpha inhibitors, highlighting paradoxical reactions such as psoriasis that occur despite being treated with medications intended to alleviate the condition.