Artosi F, Diluvio L, Vultaggio M, Campione E, Bianchi L. Mepolizumab induced palmoplantar psoriasis: A case report. World J Clin Cases 2023; 11(26): 6154-6158 [PMID: 37731552 DOI: 10.12998/wjcc.v11.i26.6154]
Corresponding Author of This Article
Fabio Artosi, MD, Academic Fellow, Doctor, Department of Systems Medicine, University of Rome “Tor Vergata”, 81 Viale Oxford, Rome 00133, Italy. fabio.artosi994@gmail.com
Research Domain of This Article
Dermatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2023; 11(26): 6154-6158 Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6154
Mepolizumab induced palmoplantar psoriasis: A case report
Fabio Artosi, Laura Diluvio, Martina Vultaggio, Elena Campione, Luca Bianchi
Fabio Artosi, Martina Vultaggio, Elena Campione, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome 00133, Italy
Laura Diluvio, Department of Dermatology, Dermatology Unit, Policlinico Tor Vergata, Rome 00133 , Italy
Luca Bianchi, Department of Dermatology, University Roma Tor Vergata, Rome 00133, Italy
Author contributions: Artosi F and Diluvio L contributed to conceptualization; Campione E contributed to methodology; Artosi F and Diluvio L contributed to investigation; Artosi F, Diluvio L, and Vultaggio M contributed to data curation; Artosi F contributed to writing and original draft preparation; Diluvio L and Bianchi L contributed to writing review and editing.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabio Artosi, MD, Academic Fellow, Doctor, Department of Systems Medicine, University of Rome “Tor Vergata”, 81 Viale Oxford, Rome 00133, Italy. fabio.artosi994@gmail.com
Received: March 14, 2023 Peer-review started: March 14, 2023 First decision: April 11, 2023 Revised: May 4, 2023 Accepted: May 24, 2023 Article in press: May 24, 2023 Published online: September 16, 2023
Abstract
BACKGROUND
Atopic dermatitis and asthma are two diseases whose pathogenesis is largely attributable to the activation, at least in the initial stages, of T helper (Th)-2 Lymphocytes, the related cytokine axis, and B lymphocytes with antibody production. Psoriasis is conversely a pathology resulting from a recruitment of Th-17 and Th-1 lymphocytes, after an initial role of innate immunity. Mepolizumab is a humanized monoclonal antibody directed against interleukin (IL)-5, a central cytokine in the Th-2 axis, therefore involved in the pathogenesis of asthma. Several authors have described the appearance of psoriatic lesions in patients with asthma or atopic dermatitis following the therapy with dupilumab, a monoclonal antibody that blocks the interleukin (IL)-4, another Th-2 cytokine.
CASE SUMMARY
We present the case of a 59-year-old patient who developed psoriasiform lesions on the palms after mepolizumab therapy for asthma, for the activation of the parallel cytokine cascade after the blockade of IL-5. We successfully treated the patient with a topical calcipotriol and betamethasone ointment.
CONCLUSION
We should investigate with further attention the possible impact on the human immunological ecosystem put in place by the inhibition of the activity of individual inflammatory mediators, so as to be able to recognize the initial adverse effects early.
Core Tip: We report the case of a 59-year-old patient with severe asthma who developed palmar psoriasis after 6 mo from the initiation of treatment with a humanized monoclonal antibody directed against interleukin-5 (IL-5), mepolizumab. There are several case reports of psoriasis induced by dupilumab therapy in the literature, but this phenomenon has not yet been recognized with modulating IL-5R signalling. This article reports the pathogenetic hypotheses that may underlie this phenomenon.
