Ann Dermatol.  2023 May;35(Suppl1):S117-S121. 10.5021/ad.21.078.

Progression of Pre-Existing Vitiligo during Secukinumab Treatment for Psoriasis

Affiliations
  • 1Department of Dermatology, Ajou University School of Medicine, Suwon, Korea

Abstract

Vitiligo has been considered an unexplained paradoxical phenomenon during biologics use. Herein, we report an adult case of progression of pre-existing vitiligo during secukinumab treatment for psoriasis, and we also examined the immunohistochemical changes in relation to biologics use. He was being administered monthly secukinumab of 300 mg dose for 2 years, and all psoriatic lesions were cleared, but pre-existing hypopigmented lesions became more distinct and larger than before unlike when using adalimumab. A skin biopsy of the hypopigmented lesion showed loss of epidermal melanocytes and absence of gp100 immune activities, and he was finally diagnosed with progression of pre-existing vitiligo. Immunohistochemical staining of vitiligo lesion showed decrease in interleukin-17 and tumor necrosis factor-α and increase in CD8+ T cells, interferon-γ, and CXCL10 after the use of secukinumab. In this study, we suggest that biologics-induced cytokine imbalance play a critical role in vitiligo progression in patients with chronic inflammatory diseases, including psoriasis.

Keyword

Biologics; Interleukin-17; Psoriasis; Secukinumab; Vitiligo
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