Brodalumab‐induced palmar pustular eruption and joint swelling accompanied by muscle pains in two cases of psoriasis

First emergence of pyoderma gangraenosum, palmoplantar pustulosis and sacroiliitis in a psoriasis patient associated with switching from secukinumab to brodalumab

“…Notably, recently, two other cases of paradoxical effects of brodalumab in the form of palmar pustulosis combined with joint swelling and muscle pain in plaque psoriasis have been reported. 6 Intriguingly, like in our case, both patients were switched to brodalumab after loss of therapeutic effectivity of secukinumab. Hence, it is conceivable that the subgroup of plaque psoriasis patients losing responsiveness to the therapeutic neutralization of IL-17A by secukinumab becomes prone to a paradoxical activation of neutrophils under IL-17RA inhibition through brodalumab.…”

Palmoplantar pustulosis emerged on a case of generalized pustular psoriasis successfully treated by secukinumab

“…When somatic mutation of skin cells occurs early in the embryonic phase, mutant cells migrate following the lines and form characteristic eruptions; this distribution is reported in some autosomal-dominant inherited skin disorders such as epidermolytic epidermal nevus or Darier disease. 4 In our case, the eruptions which had appeared from early childhood followed Blaschko lines, suggesting this mosaicism. In most previous reports of pediatric cases with TMEP, the rashes were round to patchy erythematous lesions with telangiectasia from 1.5 to 8 cm.…”

Interleukin‐17 receptor A blockade with brodalumab in palmoplantar pustular psoriasis: Report on four cases

“…Another patient developed a paradoxical reaction with new onset of pustular eruption combined with joint swelling after 4 months of treatment with brodalumab for moderate PsO which had previously shown secondary loss of efficacy of secukinumab. Side‐effects rapidly vanished after stopping IL‐17RA treatment and switching to cyclosporin‐A …”