Sarcoidosis Developing During Secukinumab Therapy: Case Report
Introduction: Sarcoidosis is a systemic granulomatous inflammatory disease with an unknown etiology and complex pathogenesis. Existing literature supports the relationship of new-onset sarcoidosis with the use of a several biologic agents. Since the skin is the second most commonly involved organ in sarcoidosis and often precedes systemic involvement, dermatologists must be able to recognize its non-specific clinical presentation.
Case Report: We present a 45 year old female with psoriatic arthritis who developed biopsy proven cutaneous sarcoidal granulomas with pulmonary involvement shortly after initiating secukinumab for treatment of psoriatic arthritis. Despite discontinuation of secukinumab, the sarcoidosis has persisted.
Discussion: This is the first case report of secukinumab, or any IL-17 inhibitor related sarcoidosis that we are aware of in the literature. Dermatologists should be aware of this as a possible side effect of secukinumab use. As the research on the role of IL-17 in the pathogenesis of sarcoidosis continues to develop, the implications of this side effect of IL-17 inhibition may have important future implications.
Amber KT, Bloom R, Mrowietz U, Hertl M. TNF-α: a treatment target or cause of sarcoidosis? J Eur Acad Dermatol Venereol. 2015 Nov;29(11):2104-11.
Mortaz E, Rezayat F, Amani D, Kiani A, Garssen J, Adcock IM, Velayati A. The Roles of T Helper 1, T Helper 17 and Regulatory T Cells in the Pathogenesis of Sarcoidosis. Iran J Allergy Asthma Immunol. 2016 Aug;15(4):334-339.
Noe MH, Rosenbach M. Cutaneous sarcoidosis. Curr Opin Pulm Med. 2017 Jun 8.
Sakthivel P, Bruder D. Mechanism of granuloma formation in sarcoidosis. Curr Opin Hematol. 2017 Jan;24(1):59-65.
Waltschew A. [Cutaneous sarcoidosis after treatment with interferon for hepatitis C: A not entirely rare but often overlooked reaction]. Pathologe. 2016 Mar;37(2):184-6.
Powell JB, Matthews P, Rattehalli R, Woodhead F, Perkins P, Powell G, Szczecinska W, Gach JE. Acute systemic sarcoidosis complicating ustekinumab therapy for chronic plaque psoriasis. Br J Dermatol. 2015 Mar;172(3):834-6.
Sacre K, Pasqualoni E, Descamps V, Choudat L, Debray MP, Papo T. Sarcoid-like granulomatosis in a patient treated by interleukin-1 receptor antagonist for TNF-receptor-associated periodic syndrome. Rheumatology (Oxford). 2013 Jul;52(7):1338-40.
Daïen CI, Monnier A, Claudepierre P, Constantin A, Eschard JP, Houvenagel E, Samimi M, Pavy S, Pertuiset E, Toussirot E, Combe B, Morel J; Club Rhumatismes et Inflammation (CRI).. Sarcoid-like granulomatosis in patients treated with tumor necrosis factor blockers: 10 cases. Rheumatology (Oxford). 2009 Aug;48(8):883-6.
Toussirot É, Aubin F. Paradoxical reactions under TNF-α blocking agents and other biological agents given for chronic immune-mediated diseases: an analytical and comprehensive overview. RMD Open. 2016;2(2):e000239.
Armstrong AW, Papp K, Kircik L. Secukinumab: Review of Clinical Evidence from the Pivotal Studies ERASURE, FIXTURE, and CLEAR. J Clin Aesthet Dermatol. 2016 Jun;9(6 Suppl 1):S7-S12.
Ostadkarampour M, Eklund A, Moller D, Glader P, Olgart Höglund C, Lindén A, Grunewald J, Wahlström J. Higher levels of interleukin IL-17 and antigen-specific IL-17 responses in pulmonary sarcoidosis patients with Löfgren's syndrome. Clin Exp Immunol. 2014 Nov;178(2):342-52.
Tan HL, Rosenthal M. IL-17 in lung disease: friend or foe? Thorax. 2013 Aug;68(8):788-90.
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