New-Onset Pyoderma Gangrenosum in a Patient with Moderate-to-Severe Plaque Psoriasis on Ixekizumab Treatment: A Case Report and Review of the Literature

Le résumé fourni par la source

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that can be challenging to manage. Although interleukin-17 (IL-17) inhibitors are among the treatment options for PG, recent reports have documented paradoxical cases of PG emerging in patients undergoing IL-17 inhibitor therapy for moderate-to-severe plaque psoriasis. In this case report, we present a case of newly developed PG in a patient treated with ixekizumab, an IL-17A inhibitor. While the causal relationship remains uncertain, the occurrence of PG during biologic therapy raises important questions regarding paradoxical inflammation and the need for differential diagnosis. Clinicians should remain vigilant for PG in psoriasis patients, especially when new ulcerative lesions appear during treatment. Regardless of whether it is paradoxical or coincidental, the emergence of PG warrants thorough clinical evaluation, with attention to potential systemic comorbidities often associated with both psoriasis and neutrophilic dermatoses.

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