A Case of Granuloma Annulare Associated with Secukinumab Use

Abstract

Granuloma annulare (GA) is a benign inflammatory dermatosis characterized clinically by dermal papules and annular plaques. The pathogenesis of GA is not well understood, although it is thought to result from a delayed-type hypersensitivity reaction in which inflammatory cells elicit connective tissue degradation. This condition has been seen following the use of several drugs, including tumor necrosis factor-alpha (TNF-α) inhibitors, which paradoxically have also been reported to treat GA. We report the case of a patient who developed GA in association with secukinumab, an interleukin-17A antagonist, and discuss its implications for our understanding of the pathogenesis of GA.

Granuloma Annulare in the Setting of Secukinumab

“…In 2017, Bonomo et al reported the first case of a patient developing GA while being treated with the interleukin 17A antagonist secukinumab [ 11 ]. Here we report a second case of a patient developing GA while on secukinumab.…”

Development or worsening of sarcoidosis associated with IL‐17 blockade for psoriasis

“…2,3 There have also been two reports of granuloma annulare occurring on IL-17 inhibitors. 4,5 Interestingly, IL-17 inhibitors are well known to induce or worsen Crohn's disease (CD), in which granuloma formation is common. [6][7][8] These observations suggest that in some patients, IL-17 inhibition might promote, rather than treat, granulomatous inflammation.…”

Disseminated granuloma annulare in one case

“…Az újonnan megjelenő efalizumab egy esetben ért el teljes remissziót generalizált GA esetében (18), de több esettanulmány súlyos mellékhatással társította (multifokális leukoencephalopathia) (19). Paradox módon néhány biológiai terápiás hatóanyag, beleértve az adalimumab, etanercept és a secukinumab hatóanyagokat, mellékhatásként granuloma anularet okoztak (20)(21)(22). Ennek a mechanizmusa máig nem tisztázott.…”