Paradoxical granulomatous reaction to ustekinumab

Author:

Obijiofor Chinemelum1ORCID,Mazori Daniel R.1,Femia Alisa N.1,Flamm Alexandra1,Caplan Avrom S.1ORCID

Affiliation:

1. The Ronald O. Perelman Department of Dermatology NYU Grossman School of Medicine New York New York USA

Abstract

AbstractSarcoidosis is a multisystem disorder characterised by granulomatous inflammation affecting various organs. The skin is commonly involved and can serve as an initial indicator of disease. While the precise aetiology of sarcoidosis remains elusive, evidence suggests involvement of T‐helper type (TH)‐1 and TH‐17 pathways. Psoriasis shares common inflammatory pathways with sarcoidosis, prompting the repurposing of biologic therapies approved for psoriasis for off‐label treatment of cutaneous sarcoidosis. However, this approach has raised concerns due to the development of granulomatous eruptions in some patients. We present a case of a patient with psoriasis who was diagnosed with systemic sarcoidosis while on ustekinumab. We review previous cases of ustekinumab‐associated sarcoidosis and discuss the challenges associated with utilising biologic agents originally intended for psoriasis treatment for sarcoidosis.

Publisher

Wiley

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