Aggravation of discoid lupus erythematosus in a patient with psoriasis and psoriatic arthritis during treatment of secukinumab: A case report and review of literature

BACKGROUND: The coexistence of psoriasis and cutaneous lupus erythematosus (LE) is uncommon. Treatment for concomitant psoriasis and LE is challenging because some valid treatments for LE such as hydroxychloroquine and systemic corticosteroid are known to aggravate psoriasis. Th17 pathway is shared by these two disease entities. Thus, biologics targeting Th17 pathway, including ustekinumab and secukinumab, have been successfully used in the treatment of patients with concomitant psoriasis and LE. PURPOSE: We report a patient with aggravation of discoid lupus erythematosus (DLE) after secukinumab treatment for psoriasis. RESEACH DESIGN: Case report. STUDY SAMPLE: One patient was included in this case report. DATA COLLECTION AND ANALYSIS: Clinical and pathological pictures were presented after informed consent. RESULT: Symptoms of psoriasis and psoriatic arthritis almost resolved after 150 mg secukinumab every four weeks for 2 years, but lesions of DLE enlarged and became generalized. CONCLUSION: LE is a highly heterogeneous disease, and further studies are required to find the optimal treatment in patients suffering from both LE and psoriasis.