Paradoxical psoriasis: The flip side of idiopathic psoriasis or an autocephalous reversible drug reaction?
Psoriasis is a common, chronic skin disease that results mainly from the complex interplay between T cells, dendritic cells, and inflammatory cytokines including TNF-α, IL-17, IL-12, and IL-23. Successful therapy with anti-cytokine antibodies has proved the importance of these key cytokines, especia...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
|
| Series: | Journal of Translational Autoimmunity |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589909023000242 |
| _version_ | 1827582000212475904 |
|---|---|
| author | Jiawei Lu Yan Lu |
| author_facet | Jiawei Lu Yan Lu |
| author_sort | Jiawei Lu |
| collection | DOAJ |
| description | Psoriasis is a common, chronic skin disease that results mainly from the complex interplay between T cells, dendritic cells, and inflammatory cytokines including TNF-α, IL-17, IL-12, and IL-23. Successful therapy with anti-cytokine antibodies has proved the importance of these key cytokines, especially TNF-α. During the anti-TNF-α treatment of classical idiopathic psoriasis, a small portion of patients develop new psoriasiform lesions. This contradictory phenomenon was named paradoxical psoriasis which resembles idiopathic psoriasis clinically but presents overlapped histological patterns and distinct immunological processes. In this review, we discuss the differences between idiopathic psoriasis and paradoxical psoriasis with an emphasis on their innate immunity, as it is predominant in paradoxical psoriasis which exhibits type I IFN-mediated immunity without the activation of autoreactive T cells and memory T cells. We also put up an instructive algorithm for the management of paradoxical psoriasis. The decision on drug discontinuation or switching of biologics should be made based on the condition of underlying diseases and the severity of lesions. |
| first_indexed | 2024-03-08T22:45:16Z |
| format | Article |
| id | doaj.art-778249bafd4f46acb9ddc7d5901100cc |
| institution | Directory Open Access Journal |
| issn | 2589-9090 |
| language | English |
| last_indexed | 2024-03-08T22:45:16Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Translational Autoimmunity |
| spelling | doaj.art-778249bafd4f46acb9ddc7d5901100cc2023-12-17T06:41:19ZengElsevierJournal of Translational Autoimmunity2589-90902023-12-017100211Paradoxical psoriasis: The flip side of idiopathic psoriasis or an autocephalous reversible drug reaction?Jiawei Lu0Yan Lu1Department of Dermatology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, PR ChinaCorresponding author. Department of Dermatology, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road; 210029; Nanjing, Jiangsu, PR China.; Department of Dermatology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, PR ChinaPsoriasis is a common, chronic skin disease that results mainly from the complex interplay between T cells, dendritic cells, and inflammatory cytokines including TNF-α, IL-17, IL-12, and IL-23. Successful therapy with anti-cytokine antibodies has proved the importance of these key cytokines, especially TNF-α. During the anti-TNF-α treatment of classical idiopathic psoriasis, a small portion of patients develop new psoriasiform lesions. This contradictory phenomenon was named paradoxical psoriasis which resembles idiopathic psoriasis clinically but presents overlapped histological patterns and distinct immunological processes. In this review, we discuss the differences between idiopathic psoriasis and paradoxical psoriasis with an emphasis on their innate immunity, as it is predominant in paradoxical psoriasis which exhibits type I IFN-mediated immunity without the activation of autoreactive T cells and memory T cells. We also put up an instructive algorithm for the management of paradoxical psoriasis. The decision on drug discontinuation or switching of biologics should be made based on the condition of underlying diseases and the severity of lesions.http://www.sciencedirect.com/science/article/pii/S2589909023000242Paradoxical psoriasisPsoriasisTumor necrosis factor inhibitorsbiological productsimmunity, innate |
| spellingShingle | Jiawei Lu Yan Lu Paradoxical psoriasis: The flip side of idiopathic psoriasis or an autocephalous reversible drug reaction? Journal of Translational Autoimmunity Paradoxical psoriasis Psoriasis Tumor necrosis factor inhibitors biological products immunity, innate |
| title | Paradoxical psoriasis: The flip side of idiopathic psoriasis or an autocephalous reversible drug reaction? |
| title_full | Paradoxical psoriasis: The flip side of idiopathic psoriasis or an autocephalous reversible drug reaction? |
| title_fullStr | Paradoxical psoriasis: The flip side of idiopathic psoriasis or an autocephalous reversible drug reaction? |
| title_full_unstemmed | Paradoxical psoriasis: The flip side of idiopathic psoriasis or an autocephalous reversible drug reaction? |
| title_short | Paradoxical psoriasis: The flip side of idiopathic psoriasis or an autocephalous reversible drug reaction? |
| title_sort | paradoxical psoriasis the flip side of idiopathic psoriasis or an autocephalous reversible drug reaction |
| topic | Paradoxical psoriasis Psoriasis Tumor necrosis factor inhibitors biological products immunity, innate |
| url | http://www.sciencedirect.com/science/article/pii/S2589909023000242 |
| work_keys_str_mv | AT jiaweilu paradoxicalpsoriasistheflipsideofidiopathicpsoriasisoranautocephalousreversibledrugreaction AT yanlu paradoxicalpsoriasistheflipsideofidiopathicpsoriasisoranautocephalousreversibledrugreaction |