case_images: PMC11807355_01
case_images: (a, b) Erythematous plaques with infiltration and scaling developed on the patient's face, extremities, and trunk 1 month after initiation of avelumab. (c, d) The histopathological findings of a plaque show hyperkeratosis, parakeratosis, granular layer thinning, rete ridge elongation, and neutrophil infiltration into the epidermis. (e, f) Despite the addition of apremilast and UV therapy to avelumab, the eruptions worsened 10 months later. (g, h) Following guselkumab initiation, a 50% reduction in the psoriasis area and severity index score was achieved at 12 weeks.
case_images: JDE-52-e147-g001.jpg
case_images: PMC11807355_01_JDE-52-e147-g001.jpg
case_images: jde17583-fig-0001
case_images: Despite achieving near-complete remission of psoriasis vulgaris with topical steroids for the past 6 months, he developed erythematous plaques with infiltration and scaling on his face, extremities, and trunk within a month of initiating avelumab for advanced urothelial carcinoma (Figure 1a,b). A skin biopsy revealed hyperkeratosis, parakeratosis, elongation of the rete ridges, and neutrophil infiltration into the epidermis (Figure 1c,d). However, 10 months after apremilast initiation, a third flare-up occurred, with the PASI score escalating to 9.6 (Figure 1e,f). Consequently, a 50% PASI improvement was observed at 12 weeks (Figure 1g,h), with further improvement to a PASI score of 1.2 at 28 weeks without AEs.