{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T01:13:03Z","timestamp":1785892383253,"version":"3.56.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Allergy"],"abstract":"<jats:p>Biologics targeting interleukin-17 (IL-17) are widely used for moderate to severe psoriasis with great efficiency. Nonetheless, their usage has sporadically resulted in paradoxical reactions, such as eczema, sarcoidosis-like eruptions, alopecia areata, and pyoderma gangrenosum. Here, we report a case of temporary facial eczema to secukinumab with a score of 5 on the Naranjo scale, which suggests a probable drug side effect. The patient was a 32-year-old Chinese male with a history of chronic plaque psoriasis for 5 years. He was previously treated with topical steroids, calcipotriol, narrowband ultraviolet B phototherapy, and oral traditional Chinese medicine intermittently since 2020. In January of 2025, his psoriasis exacerbated and was not well controlled. The patient underwent an initial regimen of 300\u2005mg secukinumab once weekly for 4 weeks, with significant psoriasis area and severity index (PASI) improvement, and was scheduled to continue maintenance therapy on a regimen of every 4 weeks. However, in the seventh week of the secukinumab treatment course, the patient's face developed diffuse, swollen, erythematous patches that had almost coalesced into sheets. The surface is smooth, without scales, blisters, or exudation, and accompanied by mild itching. Lab tests show elevated alanine aminotransferase (ALT) at 83.2\u2005U\/L (normal range: 9\u201350\u2005U\/L), slightly increased direct bilirubin at 8.48\u2005\u03bcmol\/L (normal range: 0\u20138.0\u2005\u03bcmol\/L). Other lab tests showed no significant abnormalities. After oral compound glycyrrhizin, olopatadine hydrochloride, triprolidine hydrochloride, and topical pimecrolimus for a week, his facial lesions were completely cleared. Liver function tests normalized following a 2-week course of polyenphosphatidylcholine. The patient delayed secukinumab administration by 2 weeks and continued 300\u2005mg secukinumab administration on a regimen of every 4 weeks. No recurrence of similar rash or other adverse effects was observed during the subsequent follow-up period over 5 months. It is concluded that eczema could be induced temporarily by secukinumab, and maybe continued application.<\/jats:p>","DOI":"10.3389\/falgy.2025.1672897","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T05:10:29Z","timestamp":1762837829000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Temporarily induced facial eczema by IL-17 inhibitors: a case report and literature review"],"prefix":"10.3389","volume":"6","author":[{"given":"Ting","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanzhang","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junchen","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuotao","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"740540","DOI":"10.3389\/fimmu.2021.740540","article-title":"IL-17(+) mast cell\/T helper cell axis in the early stages of acne","volume":"12","author":"Eliasse","year":"2021","journal-title":"Front Immunol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2990","DOI":"10.1038\/s41591-024-03122-3","article-title":"Sex-dependent APOE4 neutrophil-microglia interactions drive cognitive impairment in Alzheimer\u2019s disease","volume":"30","author":"Rosenzweig","year":"2024","journal-title":"Nat Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"585134","DOI":"10.3389\/fimmu.2020.585134","article-title":"Interleukin (IL)-12 and IL-18 synergize to promote MAIT cell IL-17A and IL-17F production independently of IL-23 signaling","volume":"11","author":"Cole","year":"2020","journal-title":"Front Immunol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1016\/j.jid.2023.09.275","article-title":"Inhibition of mitochondrial translation ameliorates imiquimod-induced psoriasis-like skin inflammation by targeting Vgamma4+ gammadelta T cells","volume":"144","author":"Dhillon-LaBrooy","year":"2024","journal-title":"J Invest Dermatol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1158\/2326-6066.Cir-21-0696","article-title":"Phosphoantigen-stimulated gammadelta T cells suppress natural killer-cell responses to missing-self","volume":"10","author":"Walwyn-Brown","year":"2022","journal-title":"Cancer Immunol Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"639221","DOI":"10.3389\/fimmu.2021.639221","article-title":"Circulating PD1(+)Vdelta1(+)gammadelta T cell predicts fertility in endometrial polyp patients of reproductive-age","volume":"12","author":"Li","year":"2021","journal-title":"Front Immunol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.it.2017.01.006","article-title":"IL-17 signaling: the yin and the yang","volume":"38","author":"Amatya","year":"2017","journal-title":"Trends Immunol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"108402","DOI":"10.1016\/j.intimp.2021.108402","article-title":"The role of IL-17 and anti-IL-17 agents in the immunopathogenesis and management of autoimmune and inflammatory diseases","volume":"102","author":"Berry","year":"2022","journal-title":"Int Immunopharmacol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.3390\/cimb44050127","article-title":"The treatment with interleukin 17 inhibitors and immune-mediated inflammatory diseases","volume":"44","author":"\u021aiburc\u0103","year":"2022","journal-title":"Curr Issues Mol Biol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"20406223231163110","DOI":"10.1177\/20406223231163110","article-title":"Bimekizumab for the treatment of moderate-to-severe plaque psoriasis: a meta-analysis of randomized clinical trials","volume":"14","author":"Wang","year":"2023","journal-title":"Ther Adv Chronic Dis"},{"key":"B11","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1146\/annurev-immunol-101819-092536","article-title":"IL-17 in the pathogenesis of disease: good intentions gone awry","volume":"39","author":"Majumder","year":"2021","journal-title":"Annu Rev Immunol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1501293","DOI":"10.3389\/fimmu.2024.1501293","article-title":"IL-17A in gastric carcinogenesis: good or bad?","volume":"15","author":"Li","year":"2024","journal-title":"Front Immunol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1038\/s41577-022-00746-9","article-title":"IL-17 and IL-17-producing cells in protection versus pathology","volume":"23","author":"Mills","year":"2023","journal-title":"Nat Rev Immunol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1016\/j.jaad.2024.06.106","article-title":"Risk of developing inflammatory arthritis in patients with psoriasis initiating treatment with biologics: a population-based analysis","volume":"91","author":"Strober","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1294416","DOI":"10.3389\/fimmu.2023.1294416","article-title":"Short-term risk and long-term incidence rate of infection and malignancy with IL-17 and IL-23 inhibitors in adult patients with psoriasis and psoriatic arthritis: a systematic review and meta-analysis","volume":"14","author":"Wu","year":"2023","journal-title":"Front Immunol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"141","DOI":"10.2147\/itt.S259126","article-title":"Anti-IL-17 agents in the treatment of axial spondyloarthritis","volume":"10","author":"Atzeni","year":"2021","journal-title":"Immunotargets Ther"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1372693","DOI":"10.3389\/fimmu.2024.1372693","article-title":"Interleukin inhibitors and the associated risk of candidiasis","volume":"15","author":"Khan","year":"2024","journal-title":"Front Immunol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"103818","DOI":"10.1016\/j.autrev.2025.103818","article-title":"The role of interleukin inhibitors in the treatment of hidradenitis suppurativa; a systematic review of clinical trials","volume":"24","author":"Heidari","year":"2025","journal-title":"Autoimmun Rev"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1007\/s40265-022-01750-y","article-title":"Spondyloarthropathy in inflammatory bowel disease: from pathophysiology to pharmacological targets","volume":"82","author":"Crispino","year":"2022","journal-title":"Drugs"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e173","DOI":"10.1111\/1346-8138.16308","article-title":"Treatment with an interleukin-17 inhibitor resulted in complete remission of psoriasis and flare-up of atopic dermatitis","volume":"49","author":"Hattori","year":"2022","journal-title":"J Dermatol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e60051","DOI":"10.7759\/cureus.60051","article-title":"Paradoxical eczematous reaction in a patient with IL-17 inhibitor-treated psoriasis Vulgaris","volume":"16","author":"Brazen","year":"2024","journal-title":"Cureus"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.36849\/jdd.7388","article-title":"A case series of patients with eczematous eruptions following IL-17 inhibitor treatment for psoriasis vulgaris","volume":"22","author":"Yousif","year":"2023","journal-title":"J Drugs Dermatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e32844","DOI":"10.1097\/md.0000000000032844","article-title":"Treatment of paradoxical eczematous eruption in psoriasis treated with secukinumab: a case report","volume":"102","author":"Xiao","year":"2023","journal-title":"Medicine"},{"key":"B24","doi-asserted-by":"publisher","first-page":"3521","DOI":"10.2147\/ccid.S445468","article-title":"Two cases of immune drift phenomena caused by biologic agents for treating psoriasis and atopic dermatitis","volume":"16","author":"Ma","year":"2023","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"993057","DOI":"10.3389\/fimmu.2023.993057","article-title":"Adverse events associated with anti-IL-17 agents for psoriasis and psoriatic arthritis: a systematic scoping review","volume":"14","author":"Wang","year":"2023","journal-title":"Front Immunol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19063","article-title":"Long-term efficacy, safety and tolerability of secukinumab in children and adolescents with severe chronic plaque psoriasis: two-year results from a phase III double-blind, randomized controlled trial","author":"Krasowska","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"2665","DOI":"10.1097\/cm9.0000000000001163","article-title":"Secukinumab demonstrates high efficacy and a favorable safety profile over 52 weeks in Chinese patients with moderate to severe plaque psoriasis","volume":"133","author":"Cai","year":"2020","journal-title":"Chin Med J"},{"key":"B28","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s40257-021-00586-8","article-title":"Eczematous drug eruptions","volume":"22","author":"Blum","year":"2021","journal-title":"Am J Clin Dermatol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1612422","DOI":"10.3389\/fimmu.2025.1612422","article-title":"Induced pemphigus erythematosus after treatment for plaque psoriasis with secukinumab: a case report","volume":"16","author":"Hu","year":"2025","journal-title":"Front Immunol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.jdcr.2021.03.052","article-title":"Palmoplantar pompholyx secondary to interleukin 17A inhibitor therapy for psoriasis: a case series","volume":"13","author":"Peera","year":"2021","journal-title":"JAAD Case Rep"},{"key":"B31","doi-asserted-by":"publisher","first-page":"2535","DOI":"10.1016\/j.jid.2025.02.153","article-title":"Blood single-cell transcriptomic and proteomic signatures of paradoxical eczema in patients with psoriasis treated with biologics","volume":"145","author":"Al-Janabi","year":"2025","journal-title":"J Invest Dermatol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1016\/j.jaci.2023.07.011","article-title":"Integrated proteomics and genomics analysis of paradoxical eczema in psoriasis patients treated with biologics","volume":"152","author":"Al-Janabi","year":"2023","journal-title":"J Allergy Clin Immunol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"2822","DOI":"10.1158\/1078-0432.Ccr-23-3431","article-title":"Immunologic profiling of immune-related cutaneous adverse events with checkpoint inhibitors reveals polarized actionable pathways","volume":"30","author":"Lacouture","year":"2024","journal-title":"Clin Cancer Res"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e38986","DOI":"10.7759\/cureus.38986","article-title":"Alopecia areata after initiation of secukinumab therapy for plaque psoriasis","volume":"15","author":"Choi","year":"2023","journal-title":"Cureus"},{"key":"B35","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.jdcr.2019.10.012","article-title":"Ixekizumab-induced alopecia areata","volume":"6","author":"Eldirany","year":"2020","journal-title":"JAAD Case Rep"},{"key":"B36","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1159\/000499030","article-title":"Alopecia diffusa while using interleukin-17 inhibitors against psoriasis Vulgaris","volume":"11","author":"Yajima","year":"2019","journal-title":"Case Rep Dermatol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1007\/s00403-018-1853-5","article-title":"Efficacy and safety of secukinumab treatment in adults with extensive alopecia areata","volume":"310","author":"Guttman-Yassky","year":"2018","journal-title":"Arch Dermatol Res"},{"key":"B38","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s40257-022-00699-8","article-title":"Pyoderma Gangrenosum: an updated literature review on established and emerging pharmacological treatments","volume":"23","author":"Maronese","year":"2022","journal-title":"Am J Clin Dermatol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"2229","DOI":"10.1016\/j.jid.2025.01.029","article-title":"Keratin variants in pyoderma gangrenosum: pathogenetic insights from a whole-exome sequencing-based bioinformatic analysis","volume":"145","author":"Moltrasio","year":"2025","journal-title":"J Invest Dermatol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1111\/ced.15183","article-title":"Pyoderma gangrenosum caused by secukinumab successfully treated with risankizumab: a case report and literature review","volume":"47","author":"Orita","year":"2022","journal-title":"Clin Exp Dermatol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.jdcr.2021.08.021","article-title":"Pyoderma gangrenosum in a patient on ixekizumab","volume":"16","author":"Pollack","year":"2021","journal-title":"JAAD Case Rep"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1016\/j.jid.2024.10.602","article-title":"The clinical and molecular response of pyoderma Gangrenosum to IL-23 blockade: result from a proof-of-concept open-label clinical trial","volume":"145","author":"Flora","year":"2025","journal-title":"J Invest Dermatol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1016\/j.therap.2022.12.004","article-title":"Secukinumab-induced vitiligo: a new case report and review of the literature","volume":"78","author":"Bouzid","year":"2023","journal-title":"Therapie"},{"key":"B44","doi-asserted-by":"publisher","first-page":"e15314","DOI":"10.1111\/dth.15314","article-title":"Vitiligo development in a patient with psoriasis vulgaris treated with ixekizumab","volume":"35","author":"Eker","year":"2022","journal-title":"Dermatol Ther"},{"key":"B45","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1111\/pcmr.12789","article-title":"IL-17A is not a treatment target in progressive vitiligo","volume":"32","author":"Speeckaert","year":"2019","journal-title":"Pigment Cell Melanoma Res"},{"key":"B46","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1111\/1346-8138.16765","article-title":"Two cases with bullous pemphigoid relapsed after using interleukin-17A inhibitors for psoriasis: a paradoxical reaction","volume":"50","author":"Wang","year":"2023","journal-title":"J Dermatol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"e185","DOI":"10.1111\/1346-8138.16711","article-title":"A case of bullous pemphigoid developing after ixekizumab therapy for pityriasis rubra pilaris","volume":"50","author":"Sugihara","year":"2023","journal-title":"J Dermatol"},{"key":"B48","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1111\/1346-8138.16563","article-title":"Development of pemphigus vegetans and exacerbation of pemphigus foliaceus after secukinumab loading in a patient with complicated generalized pustular psoriasis and pyoderma gangrenosum","volume":"50","author":"Minai","year":"2023","journal-title":"J Dermatol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"5918708","DOI":"10.1155\/2017\/5918708","article-title":"A case of granuloma annulare associated with secukinumab use","volume":"2017","author":"Bonomo","year":"2017","journal-title":"Case Rep Dermatol Med"},{"key":"B50","doi-asserted-by":"publisher","first-page":"e13150","DOI":"10.1111\/dth.13150","article-title":"Secukinumab-induced paradoxical hidradenitis suppurativa","volume":"33","author":"Navarro-Trivi\u00f1o","year":"2020","journal-title":"Dermatol Ther"},{"key":"B51","doi-asserted-by":"publisher","first-page":"e79","DOI":"10.1111\/ijd.15730","article-title":"Secukinumab-induced paradoxical hidradenitis suppurativa successfully treated with adalimumab","volume":"61","author":"Babino","year":"2022","journal-title":"Int J Dermatol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1111\/ddg.14976","article-title":"A possible case of brodalumab-induced ichthyosis","volume":"21","author":"Mantovani","year":"2023","journal-title":"J Dtsch Dermatol Ges"}],"container-title":["Frontiers in Allergy"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/falgy.2025.1672897\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T05:10:30Z","timestamp":1762837830000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/falgy.2025.1672897\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":52,"alternative-id":["10.3389\/falgy.2025.1672897"],"URL":"https:\/\/doi.org\/10.3389\/falgy.2025.1672897","relation":{},"ISSN":["2673-6101"],"issn-type":[{"value":"2673-6101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]},"article-number":"1672897"}}