Paradoxical Cutaneous Reaction: Secukinumab–Associated PLEVA in Palmoplantar Pustulosis
Abstract
Palmoplantar pustulosis (PPP) is a chronic inflammatory dermatosis often treated with IL-17 inhibitors like secukinumab. Paradoxical cutaneous reactions to such biologics, though rare, are increasingly recognized. We report a case of a 25-year-old woman with PPP who developed a biopsy-confirmed acute pityriasis lichenoides et varioliformis acuta (PLEVA) eruption following six weeks of secukinumab therapy. Upon switching treatment to tofacitinib, both the PPP and the paradoxical PLEVA showed significant improvement. This case highlights PLEVA as a potential paradoxical reaction to IL-17 inhibition and suggests JAK inhibitors may be an effective alternative in this scenario.
Fields of Study & Subjects
Psoriasis: Treatment and Pathogenesis
Cutaneous lymphoproliferative disorders research
Dermatology and Skin Diseases
Publication details
- Journal / source
- Journal of Inflammation Research
- Publisher
- Informa UK Limited
- Volume
- Volume 19
- Pages
- 1–5
- Publication date
- 1 February 2026
- Language
- EN