Work

Paradoxical Cutaneous Reaction: Secukinumab–Associated PLEVA in Palmoplantar Pustulosis

Year: 2026

Type: article

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.

Source: Journal of Inflammation Research

DOI: 10.2147/jir.s590485

Authors: Waner Liu, Yuan Chen, Zhimin Lin, Jianglin Zhang, Chen Li