Pyoderma gangrenosum and Behçet’s-like disease induced by secukinumab: a paradoxical drug reaction

Figures & data

Figure 1. (a) Ulcerations with undermined and erythematous borders on the left axillary fold where diffuse sinus tracts and abscesses are also seen. (b) Hyperemic papulopustular lesions and an ulceration on the sternum. (c) and (d) Oral and genital aphthous ulcerations.

Table 1. Patients’ characteristics with paradoxical pyoderma gangrenosum and Behçet’s like disease following secukinumab.

References	Sex/age (years)	Previous history	Paradoxical reaction after secukinumab	HLA-B51 positivity	Pathergy positivity	Management	Induction	Exacerbation
Shiga et al. (6)	M/56	Psoriasis	Crohn’s disease, oral ulcers, genital folliculitis	–	NA	Systemic steroid	+	–
Grimaux et al. (7)	F/36	Refractory spondylarthrosis, oral ulcers during tocilizumab therapy	Oral ulcers and inflammatory bowel disease	NA	NA	Secukinumab withdrawal, ustekinumab and systemic steroid	+	–
Dincses et al. (8)	M/34	Ankylosing spondylitis	Oral and genital ulcers, arthritis	+	+	Secukinumab withdrawal, systemic steroid and certolizumab	–	+
	M/29	Ankylosing spondylitis	Oral and genital ulcers, superficial thrombophlebitis and bilateral panuveitis	–	NA	Secukinumab withdrawal, systemic steroid and infliximab	+	–
Barrado-Solís et al. (9)	F/46	Psoriasis	High fever, oral and genital ulcers, erythema nodosum	+	+	Secukinumab withdrawal, systemic steroid	+	–
	M/48	Psoriasis and psoriatic arthropathy	Uveitis and multiple oral and perianal ulcers, painful subcutaneous nodular and papulopustular lesions	–	–	Secukinumab withdrawal, systemic steroid	+	–
Calleja Algarra et al. (10)	F/45	Psoriasis and psoriatic arthropathy	Oral and genital ulcers, papulopustular lesions	+	NA	Secukinumab withdrawal, systemic steroid	+	–
Jin et al. (11)	F/47	Psoriatic arthropathy	Pyoderma gangrenosum	NA	NA	Secukinumab withdrawal, cyclosporine	+	–
Wollina et al. (12)	F/33	Psoriasis	Pyoderma gangrenosum	NA	–	Secukinumab withdrawal, topical and systemic steroid	+	–
Petty et al. (13)	F/50	Psoriasis and palmoplantar pustulosis	Pyoderma gangrenosum	NA	NA	Secukinumab withdrawal, cyclosporine	+	–
Orita et al. (14)	M/29	Psoriasis and psoriatic arthropathy	Pyoderma gangrenosum	NA	NA	Secukinumab withdrawal	+	–
Present case	M/43	Hidradenitis suppurativa	Pyoderma gangrenosum and Behçet’s-like disease	+	–	Secukinumab withdrawal, systemic antibiotic, colchicine, topical steroid	+	–

F: female; M: male; NA: Non-applicable.

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Data availability statement

The data that support the findings are available from the corresponding author [CA] upon reasonable request.