A case of moderate hidradenitis suppurativa and psoriasis successfully treated with risankizumab

Abstract

undetected primary gonadal GCT which may have regressed spontaneously, especially a testicular tumor. [1][2][3] Primary and metastatic (also called secondary) germ cell tumors account for approximately one quarter of all retroperitoneal tumors. 2,3 For both primary and secondary tumors, serum tumor marker detection could help with diagnosis (e.g., alpha-fetoprotein, human chorionic gonadotropin), as well as they are markers of tumor relapse. 2,3 However, the existence of the so-called primary EGCT of the retroperitoneum is still a matter of debate, 3,4 and they should be considered to be metastases of a viable or burned-out testicular cancer until proven otherwise. 1,3 Both extragonadal and gonadal germ cell tumors involving the skin are extremely rare, and when they occur, most lesions are true mature teratomas. 4 The prognosis is variable according to the disease extension and systemic dissemination. 4 Curative treatment is achieved after wide excision whenever it is possible. Chemotherapy and radiotherapy are recommended as adjuvant to surgery and for metastatic disease. 4 To date, there is one report of malignant primary EGCT located in the scalp in a child and another report of a mixed nonseminomatous germ cell tumor presenting as a subcutaneous tissue mass. 1,5 Cutaneous EGCT can be difficult to differentiate from a primary malignant neoplasm, sarcoma, or a skin metastasis. Dermatologists must be attentive in order to early recognize cutaneous manifestations of EGCT to increase the suspicion of these rare presentations of this life-threatening disease.

Paradoxical Hidradenitis Suppurativa during Biologic Therapy, an Emerging Challenge: A Systematic Review

“…Anti-IL 23 drugs (guselkumab, risankizumab, tildrakizumab) represent the latest class of biologics approved for the treatment of moderate to severe psoriasis [ 43 , 44 , 45 , 46 ]. To date, the efficacy and safety of anti-IL 23 in the management of HS have been described only in some case series, showing contrasting results [ 47 , 48 , 49 , 50 ]. Indeed, the precise role of IL 23 in HS is not yet fully understood.…”

Insights into the Pathogenesis of HS and Therapeutical Approaches

“…After 3 months of therapy, HiSCR was achieved by both female patients and the male patient presented a complete clinical response of both diseases 16 weeks after starting risankizumab. No serious adverse events were reported (only one mild adverse event occurred: an episode of tonsillitis) [254,255].…”

New perspectives on the treatment of hidradenitis suppurativa

“…Three publications report clinical response to risankizumab in four patients treated at psoriasis doses (150 mg sc at week 0, week 4, and every 12 weeks thereafter). [184][185][186] A phase II, double-blind RCT to evaluate the safety and efficacy of two dose levels of risankizumab in adult patients with moderate-to-severe HS is being conducted (NCT03926169). 187 Tildrakizumab is a humanized monoclonal antibody that targets the p19 subunit of IL-23.…”