Cutaneous hyperpigmentation induced by apremilast

Cutaneous hyperpigmentation induced by apremilast Case reportApremilast is an oral inhibitor of phosphodiesterase‐4 (PDE4) recently approved for the treatment of psoriasis and psoriatic arthritis (PsA).We report the case of a 70‐year‐old female patient affected with severe psoriasis and PsA for more than 30 years, who developed cutaneous skin hyperpigmentation while treated with oral apremilast 30 mg/bid (Fig. ).Patient before (a) and during apremilast treatment (b) exhibiting increase in size and darkening of the solar lentigines resembling intense UV exposureOver decades, she had been variously treated with PUVA, acitretin, cyclosporine‐A, and methotrexate. She was also treated with infliximab first and then adalimumab with optimal response of cutaneous and articular symptoms; however, during both biologics she developed ANA‐positivity with levels up to 1:1280 that were completely reversible after treatment suspension.Eight weeks after adalimumab discontinuation, the patient presented with a psoriasis area and severity index (PASI) score of 5, severe morning stiffness, visual analog scale (VAS) pain 6, important functional limitation with tender, swollen, and painful II, III, IV‐distal interphalangeal (DIP) and metacarpophalangeal (MCP) joints of both hands, and ultrasonographic active tenosynovitis of all the involved articulations. In addition, she developed new PsA symptoms at the right ankle and metatarsal sites of the right foot.The patient had http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Dermatology Wiley

Loading next page...
 
/lp/wiley/cutaneous-hyperpigmentation-induced-by-apremilast-uoo4fPfsvX
Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
International Journal of Dermatology © 2018 International Society of Dermatology
ISSN
0011-9059
eISSN
1365-4632
D.O.I.
10.1111/ijd.13831
Publisher site
See Article on Publisher Site

Abstract

Case reportApremilast is an oral inhibitor of phosphodiesterase‐4 (PDE4) recently approved for the treatment of psoriasis and psoriatic arthritis (PsA).We report the case of a 70‐year‐old female patient affected with severe psoriasis and PsA for more than 30 years, who developed cutaneous skin hyperpigmentation while treated with oral apremilast 30 mg/bid (Fig. ).Patient before (a) and during apremilast treatment (b) exhibiting increase in size and darkening of the solar lentigines resembling intense UV exposureOver decades, she had been variously treated with PUVA, acitretin, cyclosporine‐A, and methotrexate. She was also treated with infliximab first and then adalimumab with optimal response of cutaneous and articular symptoms; however, during both biologics she developed ANA‐positivity with levels up to 1:1280 that were completely reversible after treatment suspension.Eight weeks after adalimumab discontinuation, the patient presented with a psoriasis area and severity index (PASI) score of 5, severe morning stiffness, visual analog scale (VAS) pain 6, important functional limitation with tender, swollen, and painful II, III, IV‐distal interphalangeal (DIP) and metacarpophalangeal (MCP) joints of both hands, and ultrasonographic active tenosynovitis of all the involved articulations. In addition, she developed new PsA symptoms at the right ankle and metatarsal sites of the right foot.The patient had

Journal

International Journal of DermatologyWiley

Published: Jan 1, 2018

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches

$49/month

Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.

$588

$360/year

billed annually
Start Free Trial

14-day Free Trial