De-novo-Auftreten einer Vitiligo unter IL-12/23-Inhibitor-Therapie einer chronischen Plaque-Psoriasis

Zusammenfassung

Wir berichten über einen 54-jährigen männlichen Patienten mit seit über 13 Jahren bestehender chronischer Plaque-Psoriasis und metabolischem Syndrom, der über 5 Jahre nach Beginn einer s. c. Therapie mit einem Interleukin-12/23-Inhibitor (Ustekinumab) eine Vitiligo in den seitlichen Gesichtspartien entwickelte. Vier Monate zuvor wurde wegen eines neu diagnostizierten Diabetes mellitus Typ 2 eine s. c. Insulin-Therapie begonnen. Das Neuauftreten einer Vitiligo als paradoxe Reaktion auf eine Biologika-Therapie mit TNF-alpha-, Interleukin-12/23- und Interleukin-17-Inhibitoren wurde bisher in nur wenigen Einzelfällen beschrieben, ein Zusammenhang mit einer Insulin-Therapie meist nur bei autoimmunologisch bedingtem Typ-1-Diabetes.

Abstract

We report on a 54-year-old male patient with chronic plaque psoriasis for 13 years and metabolic syndrome, who developed a vitiligo more than 5 years after start of an s. c. therapy with an interleukin-12/23 inhibitor (Ustekinumab) of the lateral parts of his face. Four months earlier subcutaneous insulin treatment was started due to a newly diagnosed diabetes mellitus type 2. The onset of vitiligo as paradoxical reaction to biologics therapy with TNF-alpha-, interleukin-12/23- and interleukin-17-inhibitors has been described in only few cases, an association with insulin treatment mostly with autoimmune caused type 1 diabetes mellitus.

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