Comorbid psoriasis-bipolar disorder successfully treated with apremilast: much more than a mere coincidence?

Abstract

Psoriasis is a chronic, immune mediated, systemic inflammatory skin disease with a reported prevalence of 0.6%–4.8% in the general population. Bipolar disorder (BP) is a severe episodic psychiatric disorder that ranks as the fourth leading cause of disability. Recent evidence suggests that genetic and immunological factors play a significant role in the development of both disorders. Studies have also shown a higher association of psychiatric disorders among patients with psoriasis. Moreover, several autoimmune comorbidities have been reported in association with BP. Here, we describe a young woman with BP who developed psoriasis after 1 year of developing BP and showed exacerbations in psoriasis lesions with each manic episode. We also highlight the safe and efficacious use of apremilast for psoriatic lesions in the woman.

Apremilast in psoriasis patients with serious comorbidities: a case series and systematic review of literature

“…Furthermore, many biologics (adalimumab, certolizumab pegol, etanercept, infliximab, ustekinumab, guselkumab, risankizumab, brodalumab, secukinumab, ixekizumab) can be used in patients receiving highly active antiretroviral therapy (HAART) and having undetectable viral load [19]. In case of detectable Cohen-Sors 2021 [13] Hematologic malignancy: 10 Gottlieb 2021 [36] Kahn 2019 [37] Nagata 2019 [38] Uvais 2020 [39] Vico-Alonso 2020 [40] Melis 2020 [41] Perrone 2017…”

Triggers for the onset and recurrence of psoriasis: a review and update

“…Even the association between parental common mental disorders (anxiety and depression) and offspring's risk of psoriasis has been determined [ 165 ]. Another study reported a woman with bipolar disorder subsequently developed psoriasis and experienced exacerbations in psoriatic lesions during each manic episode [ 166 ]. In accordance with the clinically elevated psoriatic inflammation in patients with autistic spectrum disorder, Nadeem et al reported a high level of systemic inflammation in autistic mouse models, suggesting the link between autism and psoriasis activity [ 167 ].…”