Korean J Dermatol.  2022 Dec;60(10):679-682.

A Case of Rebound Phenomenon after Cessation of Cyclosporine for Guselkumab Therapy in Psoriasis

• Park SH
• Jung SY

Abstract

Cyclosporine is one of the main therapeutic agents for psoriasis. It is known that psoriasis relapses 2∼3 months after discontinuation of cyclosporine, and exacerbation due to abrupt discontinuation of cyclosporine is uncommon. We report a case of psoriasis that was aggravated by cyclosporine cessation for guselkumab treatment, but improved with continuous administration of guselkumab. A 55-year-old man with a history of psoriasis presented with erythematous scaly plaques on the whole body. He had been treated with cyclosporine for 18 months and had received a subcutaneous injection of guselkumab 1 month previously. Two weeks after the first injection, the patient experienced exacerbation of the lesions. Considering the aggravation caused by abrupt discontinuation of cyclosporine, guselkumab administration was continued. The aggravated psoriatic lesions improved after additional guselkumab injections. At 16 weeks, the Psoriasis Area and Severity Index score was 0, which remained constant thereafter.

Keyword

Biological products; Cyclosporine; Guselkumab; Psoriasis