Long-term remission of severe psoriasis following CD19-directed chimeric antigen receptor T-cell therapy for follicular lymphoma

Psoriasis is a chronic, immune-mediated inflammatory disease in which durable, treatment-free remission is rarely achieved despite highly effective biologic therapies. We report a 60-year-old woman with a 49-year history of severe, treatment-refractory plaque psoriasis who developed complete and sustained disease clearance following autologous CD19-directed chimeric antigen receptor (CAR) T-cell therapy for follicular lymphoma. Psoriasis resolved within four weeks of CD19 CAR-T-cell therapy and has remained in remission for over 4.5 years without any psoriasis-directed treatment. This observation, together with emerging reports, suggests that deep tissue depletion of B-lymphoid lineage cells in psoriasis may induce long-term disease modification. Mechanistically, CD19 CAR-T therapy targets a broader spectrum of B-cell populations than anti-CD20 approaches, potentially disrupting pathogenic B-T cell interactions and autoreactive immune circuits. These findings challenge the prevailing T cell-centric paradigm of psoriasis and support exploration of B-cell-directed, immune reset strategies as a route towards durable remission or cure.