Awareness of the Risk of Paradoxical Psoriasis in Patients with SAPHO Syndrome Undergoing Treatment with Secukinumab: A Case Series

Cheng Xu,* Xiayan Xu,* Yongmei Han Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongmei Han, Department of Rheumatology, Sir Ru...

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Main Authors: Xu C, Xu X, Han Y
Format: Article
Language:English
Published: Dove Medical Press 2025-03-01
Series:Journal of Inflammation Research
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Online Access:https://www.dovepress.com/awareness-of-the-risk-of-paradoxical-psoriasis-in-patients-with-sapho--peer-reviewed-fulltext-article-JIR
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author Xu C
Xu X
Han Y
author_facet Xu C
Xu X
Han Y
author_sort Xu C
collection DOAJ
description Cheng Xu,* Xiayan Xu,* Yongmei Han Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongmei Han, Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3#Qingchun East Road, Hangzhou, 310016, People’s Republic of China, Email 3408235@zju.edu.cnAbstract: SAPHO syndrome is a systemic inflammatory disease characterized by skin lesions and inflammatory changes in the bones and joints. There is no consensus on the treatment strategy of SAPHO syndrome. For patients with refractory SAPHO syndrome, biological agents can be considered. We report three patients who responded poorly to conventional therapy, all of whom had paradoxical recurrence of pustulosis after receiving secukinumab, and whose paradoxical pustulosis resolved after adjustment to tofacitinib. We reviewed the literature and concluded that secukinumab may be potentially risky for the treatment of SAPHO syndrome. This paradoxical aggravation of the rash may be related to paradoxical psoriasis. The specific pathogenesis is not clear, and tofacitinib may be a remedy for this situation.Keywords: SAPHO, PPP, IL-17, secukinumab, paradoxical psoriasis
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issn 1178-7031
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publishDate 2025-03-01
publisher Dove Medical Press
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series Journal of Inflammation Research
spelling doaj-art-47e840422d2e4ae8a09cf925d62962632025-08-20T02:57:13ZengDove Medical PressJournal of Inflammation Research1178-70312025-03-01Volume 1837053712101061Awareness of the Risk of Paradoxical Psoriasis in Patients with SAPHO Syndrome Undergoing Treatment with Secukinumab: A Case SeriesXu CXu XHan YCheng Xu,* Xiayan Xu,* Yongmei Han Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongmei Han, Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3#Qingchun East Road, Hangzhou, 310016, People’s Republic of China, Email 3408235@zju.edu.cnAbstract: SAPHO syndrome is a systemic inflammatory disease characterized by skin lesions and inflammatory changes in the bones and joints. There is no consensus on the treatment strategy of SAPHO syndrome. For patients with refractory SAPHO syndrome, biological agents can be considered. We report three patients who responded poorly to conventional therapy, all of whom had paradoxical recurrence of pustulosis after receiving secukinumab, and whose paradoxical pustulosis resolved after adjustment to tofacitinib. We reviewed the literature and concluded that secukinumab may be potentially risky for the treatment of SAPHO syndrome. This paradoxical aggravation of the rash may be related to paradoxical psoriasis. The specific pathogenesis is not clear, and tofacitinib may be a remedy for this situation.Keywords: SAPHO, PPP, IL-17, secukinumab, paradoxical psoriasishttps://www.dovepress.com/awareness-of-the-risk-of-paradoxical-psoriasis-in-patients-with-sapho--peer-reviewed-fulltext-article-JIRsapho,ppp,il-17,secukinumab,paradoxical psoriasis
spellingShingle Xu C
Xu X
Han Y
Awareness of the Risk of Paradoxical Psoriasis in Patients with SAPHO Syndrome Undergoing Treatment with Secukinumab: A Case Series
Journal of Inflammation Research
sapho,ppp,il-17,secukinumab,paradoxical psoriasis
title Awareness of the Risk of Paradoxical Psoriasis in Patients with SAPHO Syndrome Undergoing Treatment with Secukinumab: A Case Series
title_full Awareness of the Risk of Paradoxical Psoriasis in Patients with SAPHO Syndrome Undergoing Treatment with Secukinumab: A Case Series
title_fullStr Awareness of the Risk of Paradoxical Psoriasis in Patients with SAPHO Syndrome Undergoing Treatment with Secukinumab: A Case Series
title_full_unstemmed Awareness of the Risk of Paradoxical Psoriasis in Patients with SAPHO Syndrome Undergoing Treatment with Secukinumab: A Case Series
title_short Awareness of the Risk of Paradoxical Psoriasis in Patients with SAPHO Syndrome Undergoing Treatment with Secukinumab: A Case Series
title_sort awareness of the risk of paradoxical psoriasis in patients with sapho syndrome undergoing treatment with secukinumab a case series
topic sapho,ppp,il-17,secukinumab,paradoxical psoriasis
url https://www.dovepress.com/awareness-of-the-risk-of-paradoxical-psoriasis-in-patients-with-sapho--peer-reviewed-fulltext-article-JIR
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