中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (9): 652-656.doi: 10.12144/zgmfskin202609652

• 病例报告 • 上一篇    下一篇

乌帕替尼治疗司库奇尤单抗诱发加重的红皮病型银屑病一例

徐晨,张东,孙锐,罗增香,马伟元   

  1. 山东第二医科大学附属医院皮肤科，山东潍坊，261000
  • 出版日期:2026-09-15 发布日期:2026-09-02

Upadacitinib for the treatment of secukinumab-induced exacerbation of erythrodermic psoriasis: a case report

XU Chen, ZHANG Dong, SUN Rui, LUO Zengxiang, MA Weiyuan   

  1. Department of Dermatology, Affiliated Hospital of Shandong Second Medical University, Weifang 261000, China
  • Online:2026-09-15 Published:2026-09-02

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摘要： 红皮病型银屑病（erythrodermic psoriasis，EP）具有病情顽固、复发率高、治疗抵抗等特点,皮下注射司库奇尤单抗是有效的治疗手段，其诱发皮损加重的病例较为罕见。本文报道1例79岁女性EP患者，经阿维 A、甲氨蝶呤治疗效果不佳，予以司库奇尤单抗治疗后皮损与瘙痒进行性加重，停用司库奇尤单抗，改用乌帕替尼口服治疗。治疗3天后瘙痒显著缓解，皮损颜色转暗；治疗4周后，PASI评分改善达90%。本例提示，对于IL-17抑制剂治疗后加重的EP患者，JAK1抑制剂可能是一种有效的治疗选择。

关键词: 红皮病型银屑病, 乌帕替尼, 司库奇尤单抗, JAK1抑制剂

Abstract: Erythrodermic psoriasis (EP) is characterized by intractable disease, a high recurrence rate and poor response to conventional therapies. Subcutaneous secukinumab represents an effective therapeutic option for EP, yet cases of exacerbated cutaneous lesions induced by this agent are rarely reported. Herein, we report a 79-year-old female patient with EP who failed to respond to acitretin and methotrexate. Progressive worsening of skin lesions and pruritus occurred following secukinumab administration, so the drug was discontinued and switched to oral upadacitinib. Marked relief of pruritus and darkening of lesions were observed 3 days after treatment initiation, and a 90% improvement in PASI score was achieved at week 4. This case suggests that JAK1 inhibitors may serve as an effective alternative for EP patients experiencing disease deterioration after treatment with IL-17 inhibitors.

Key words: erythrodermic psoriasis, upadacitinib, secukinumab, JAK1 inhibitors