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This case marks the first reported instance of transverse myelitis in a patient receiving guselkumab. Greater awareness of this potential adverse event is suggested prior to starting this treatment, particularly in patients with evidence of demyelinating lesions in their central nervous system. Additional studies are needed to evaluate the safety of guselkumab in these patients. We provide a review of psoriasis treatments and highlight those that have been shown to exacerbate neuroinflammatory conditions, like multiple sclerosis, which can lead to attacks of demyelination.<\/jats:p>","DOI":"10.1136\/bcr-2025-266114","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T04:05:20Z","timestamp":1750219520000},"page":"e266114","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Transverse myelitis following guselkumab treatment for severe plaque psoriasis"],"prefix":"10.1136","volume":"18","author":[{"given":"Nara Miriam","family":"Michaelson","sequence":"first","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Harvard University, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart K","family":"Chwalisz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Harvard University, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"2025082707455700000_18.6.e266114.1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.339"},{"key":"2025082707455700000_18.6.e266114.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61909-7"},{"key":"2025082707455700000_18.6.e266114.3","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/S0140-6736(20)32549-6","article-title":"Psoriasis","volume":"397","author":"Griffiths","year":"2021","journal-title":"The 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