The goal of the study was to provide an overview of dermatologic adverse events (AEs) related to biologics used for psoriasis and to compare common dermatologic AEs across different biologic classes.

This study entailed a comprehensive search from MEDLINE. The selection process included two reviewers. The selected studies (n = 127) included patients with plaque-type psoriasis, treated with biologics, who experienced more than 1 dermatologic AE. 

The results delineated a 4.17% AE rate for tumor necrosis factor-α (TNF-α) inhibitors, a 9.49% AE rate for interleukin (IL)-12/23 inhibitor, 12.40% AE rate for IL-17 inhibitors and 7.37% AE rate for IL-23 inhibitors.

The AEs associated with the biologics included – allergic skin reactions, skin infections, inflammatory skin diseases, skin neoplasms and miscellaneous. Skin neoplasms––mainly nonmelanoma type––predominated among TNF-α inhibitors, whereas, allergic skin reactions were the most common side effect with IL-12/23 inhibitor. Meanwhile, IL-17 inhibitors predisposed to skin infections – often, mucocutaneous candidiasis and inflammatory skin disease, mainly eczematous eruptions, were frequent with IL-23 inhibitors.

The difference in specific targets of action causes the predominance of specific dermatologic AEs in distinct biologic classes. Further study on the mechanisms of these potential AEs with aid in their prevention and management. 

Source: Palakornkitti P, Nimmannitya K, Rattanakaemakorn P. Biological therapy in psoriasis: An emphasis on its dermatologic adverse events. Asian Pac J Allergy Immunol. 2021;39(4):215-30.