Prurigo Nodularis Onset during IL-17A Inhibitor Treatment of Psoriasis: A Case Report

Abstract

Background: secukinumab has been approved by the U.S. FDA and the European Medicines Agency for the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis. Here we report a case of prurigo nodularis during the treatment of psoriasis with secukinumab, which has never been reported before. Case introduction: the patient was a 22-years-old male with a 6-month history of severe plaque paoriasis vulgaris, who received regular treatment with satisfactory control of the psoriatic rash, and was seen for 1 week for red papules and nodules with pruritus on the trunk and extremities. Dermatologic condition: multiple edematous red firm papules on the trunk and extremities in the form of soy or hemispherical nodules, with some tops visible as ulcerated crusts, red in color, firm to touch, and negative Auspitz sign. Pathological examination confirmed prurigo nodularis (PN). Conclusion: This case is shared to inform clinicians about yet another adverse effect of the IL-17A inhibitor in the treatment of psoriasis. It is recommended that patients be carefully informed of the possible risk of prurigo nudularis before starting treatment.