Successful Treatment of Paradoxical Psoriasis with IL 17 Inhibition: Case Reports

Paradoxical psoriasis (PPs) is new-onset psoriatic skin lesions or worsening of the existing psoriatic skin lesions during anti-TNF therapy. PPs occurs in 2-5% of patients using anti TNF drugs (1). It is a class effect of anti-TNF agents rather than a drug effect and has been observed with all diseases for which TNF-a inhibitors are indicated (2). The time between the starting treatment and the appearance of lesions can range from a few days to years. Discontinuation of anti-TNF therapy, replacement of biological agents, or continued adjuvant therapy are among the treatment options. Inhibition of IL17 can lead to a decrease in PPs and rheumatic disease activity. We aimed to discuss the treatment process and secukinumab in three cases in PPs and to discuss the remission with IL-17 inhibition.