Biologics are the most
advanced treatment for
psoriasis.
Ustekinumab, one of the
biologics for
psoriasis, is a
human monoclonal antibody that binds to the p40 subunit of
interleukin-12 and
interleukin-23. A 41-year-old
woman with a 17-year
history of plaque
psoriasis and
psoriatic arthritis presented with worsening lesions. The
patient had previously been treated with a number of topical and systemic medications and narrow band ultraviolet B. However, none of the
treatments consistently controlled
her disease. Thus,
treatment with
ustekinumab 45 mg via
subcutaneous injection was initiated. Approximately 7 days after the first
treatment, she experienced a flare with generalized pustules in her whole body. The condition was controlled with systemic
steroid treatment. The
patient was subsequently treated with
adalimumab, and improvement in her plaque and pustular lesions was noted. Herein, we
report a case of
psoriasis that flared up after
ustekinumab therapy, which was accompanied by a morphological change from plaque to pustular lesions.