KMID : 1149120210180020043
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Journal of the Korean Society for Psoriasis 2021 Volume.18 No. 2 p.43 ~ p.45
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A Case of Reactivation of Latent Tuberculosis during Biologics Treatment in a Patient with Psoriasis
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Kim Chang-Yong
Cho Young-Ah Kim Sung-Min Hong Ji-Youn Lee Yang-Won Ahn Kyu-Joong Choe Yong-Beom
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Abstract
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A 44-year-old male patient with a 15-year history of plaque-type psoriasis visited our dermatologic clinic. In screening tests for latent tuberculosis (TB) infection, both interferon-gamma release assay and purified protein derivative skin test showed positive results. As chest radiography showed no specific findings and the patient had no respiratory symptoms, isoniazid was administered for 9 months. For the treatment of psoriasis, ustekinumab was started. The patient was treated with ustekinumab for 5 years followed by secukinumab for 47 weeks. Thereafter, owing to a decrease in drug efficacy, guselkumab was started. At 21 weeks after treatment with guselkumab, a chest radiograph showed findings suspicious for TB. Subsequent chest computed tomography revealed active TB, and the patient was referred to a pulmonologist for further evaluation. Biologics are considered safe for the treatment of psoriasis. However, in patients with long-term administration of multiple biologics, the risk of TB reactivation should not be overlooked.
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KEYWORD
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Biologics, Latent tuberculosis, Psoriasis
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