Hair whitening in a patient with psoriasis on adalimumab reversed after switching to ixekizumab

Abstract

A 79-year-old otherwise healthy Puerto Rican woman is seen for a 3-month history of a rapidly enlarging mass on her right foot. The involved areas are occasionally tender, affecting her ability to walk. Physical examination reveals many confluent, deep red to purple, eroded, grapelike nodules affecting all aspects of the foot

Onset of vitiligo in a psoriasis patient on ixekizumab

“…The relationship between psoriasis and melanogenesis, as well as the connection between biologics and vitiligo, has yet to be confirmed. One case of TNFα induced vitiligo, resolved after ixekizumab therapy, has recently been described 6 …”

“…One case of TNFα induced vitiligo, resolved after ixekizumab therapy, has recently been described. 6 Biologics inhibiting the Th17 pathway have recently been introduced on the market; consequently data about paradoxical adverse effects are not so wide. The most common adverse effects of anti IL17 were nasopharyngitis, upper respiratory tract infections, headache, and arthralgia, which are rarely associated with therapy discontinuation.…”

Role of Cytokines in Vitiligo: Pathogenesis and Possible Targets for Old and New Treatments

“…The maintenance of the biological therapy after the onset of vitiligo led to stable disease or repigmentation in the majority of cases, whereas the use of biological agents in patients with pre-existing vitiligo had an unfavorable outcome, with vitiligo progression in 43.7% of cases and repigmentation in only one out of eighteen patients [ 71 ]. The onset of vitiligo during the treatment with adalimumab [ 74 , 77 , 78 , 79 , 80 , 81 ] and infliximab [ 82 , 83 , 84 , 85 , 86 , 87 , 88 ] for other inflammatory diseases has been widely reported in the literature. The occurrence of vitiligo in patients treated with anti-TNFα has limited their use, although they appear hopeful in stopping the progression of the disease.…”