Oral lichenoid reaction in a psoriatic patient treated with secukinumab: A drug-related rather than a class-related adverse event?

Concurrent chronic hyperplastic candidosis and oral lichenoid lesion as adverse events of secukinumab therapy

“…Urticaria and rare cases of anaphylactic reaction to secukinumab have been observed 2 . There have also been three case reports of purported oral lichenoid lesions and/or oral lichen planus reported in the literature, 7–9 but none of chronic hyperplastic candidosis.…”

Bullous acral eruption related to secukinumab

“…Reported skin related adverse events from phase 3 trials of secukinumab for psoriasis include oral herpes, urticaria, tinea pedis, oral candidiasis, and impetigo, though case reports of other cutaneous reactions have been reported (Table 1), [4,[6][7][8][9][10][11][12][13][14][15][16][17][18]. The Naranjo score is a tool that can help determine the likelihood that a medication in question is responsible for the adverse reaction, which in this case is three (Table 2), [19].…”

“…However, details specific to this patient's course make the score's interpretation imperfect, with a score of three indicating only possible causality. In this case, Truncal pruritic and psoriasiform eruptions [6][7][8] Lichen planus/lichenoid reaction [9][10][11][12] Bullous pemphigoid [13] Subacute cutaneous lupus erythematosus [14] Severe mucositis [15] Granuloma annulare [16] Dermatophytosis [17] Recurrent angular cheilitis [18] Dermatology Online Journal || Case Presentation secukinumab was only made publicly available in 2015 and so reports of reactions are limited. As the patient's reaction was severe and led to hospital admission, rechallenge of the medication was not done, particularly since multiple alternative treatments exist for psoriasis.…”

Comment on “Oral lichenoid reaction in a psoriatic patient treated with secukinumab: A drug-related rather than a class-related adverse event?”

“…To the Editor : We read with great interest the report by Capusan et al, 1 concerning an oral lichenoid eruption that developed in a psoriatic patient while treated with the interleukin (IL)-17A inhibitor, secukinumab (SEK). In that case, treatment discontinuation led to a complete resolution of the eruption, suggesting a causative role of the drug.…”

“…In that case, treatment discontinuation led to a complete resolution of the eruption, suggesting a causative role of the drug. Moreover, the eruption did not recur during treatment with the other IL-17 inhibitor, ixekizumab, allowing speculation that oral lichenoid reactions may represent a drug-related adverse event, rather than a class-related one 1 …”