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已发表论文
在依奇珠单抗治疗银屑病期间接种人乳头瘤病毒疫苗后出现的爆发性脂溢性角化病：一例病例报告及文献综述
Authors Chen G, Hu X, Li Y , Yao L
Received 6 July 2025
Accepted for publication 22 October 2025
Published 14 November 2025 Volume 2025:18 Pages 3021—3028
DOI https://doi.org/10.2147/CCID.S551973
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Prof. Dr. Rungsima Wanitphakdeedecha
Gaihe Chen,1 Xiaohuan Hu,2 Yuan Li,2 Liping Yao1
1Department of Dermatology, the Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China; 2Department of Cosmetic Dermatology, the Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
Correspondence: Liping Yao, Department of Dermatology, the Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou, Hainan, 570100, People’s Republic of China, Email 1245522564@qq.com Yuan Li, Department of Cosmetic Dermatology, the Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou, Hainan, 570100, People’s Republic of China, Email liyuanskin@hotmail.com
Abstract: Psoriasis is a chronic, recurrent, inflammatory autoimmune skin disease. The advent of biologics, such as ixekizumab, has provided a breakthrough for patients with moderate-to-severe disease by specifically inhibiting the interleukin-17A (IL-17A) mediated inflammatory cascade. The human papillomavirus (HPV) vaccine is a cornerstone in the prevention of HPV-associated malignancies, with well-established safety and efficacy profiles. However, due to the unique immune status of patients with psoriasis, cutaneous adverse events following HPV vaccination during biologic therapy have rarely been reported. Seborrheic keratosis (SK) is a common benign epidermal tumour. Its eruptive variant, known as the Leser-Trélat sign, has traditionally been associated with internal malignancies; however, recent studies suggest potential links to inflammation, pharmacological agents, and immune alterations. We report the case of a 37-year-old female with psoriasis who, after achieving stable disease control on ixekizumab, developed widespread eruptive brown macules, patches, and papules within one month of receiving a quadrivalent HPV vaccine. Histopathological examination confirmed SK, and malignancy, as well as other associated disorders, were excluded. The lesions faded following oral acitretin therapy. This case highlights the possibility that ixekizumab in combination with HPV vaccination may synergistically alter immune homeostasis, thereby precipitating eruptive SK. We discuss potential mechanisms, propose clinical management considerations, and provide insights that may inform future research and clinical practice. The ultimate aim is to contribute to the refinement of guidelines on vaccination in patients receiving biologic therapy for psoriasis, ensuring both therapeutic efficacy and patient safety.
Keywords: ixekizumab, psoriasis, HPV vaccine, seborrheic keratosis, vaccine adverse reaction, immune activation, autoimmune response
1Department of Dermatology, the Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China; 2Department of Cosmetic Dermatology, the Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
Correspondence: Liping Yao, Department of Dermatology, the Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou, Hainan, 570100, People’s Republic of China, Email 1245522564@qq.com Yuan Li, Department of Cosmetic Dermatology, the Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou, Hainan, 570100, People’s Republic of China, Email liyuanskin@hotmail.com
Abstract: Psoriasis is a chronic, recurrent, inflammatory autoimmune skin disease. The advent of biologics, such as ixekizumab, has provided a breakthrough for patients with moderate-to-severe disease by specifically inhibiting the interleukin-17A (IL-17A) mediated inflammatory cascade. The human papillomavirus (HPV) vaccine is a cornerstone in the prevention of HPV-associated malignancies, with well-established safety and efficacy profiles. However, due to the unique immune status of patients with psoriasis, cutaneous adverse events following HPV vaccination during biologic therapy have rarely been reported. Seborrheic keratosis (SK) is a common benign epidermal tumour. Its eruptive variant, known as the Leser-Trélat sign, has traditionally been associated with internal malignancies; however, recent studies suggest potential links to inflammation, pharmacological agents, and immune alterations. We report the case of a 37-year-old female with psoriasis who, after achieving stable disease control on ixekizumab, developed widespread eruptive brown macules, patches, and papules within one month of receiving a quadrivalent HPV vaccine. Histopathological examination confirmed SK, and malignancy, as well as other associated disorders, were excluded. The lesions faded following oral acitretin therapy. This case highlights the possibility that ixekizumab in combination with HPV vaccination may synergistically alter immune homeostasis, thereby precipitating eruptive SK. We discuss potential mechanisms, propose clinical management considerations, and provide insights that may inform future research and clinical practice. The ultimate aim is to contribute to the refinement of guidelines on vaccination in patients receiving biologic therapy for psoriasis, ensuring both therapeutic efficacy and patient safety.
Keywords: ixekizumab, psoriasis, HPV vaccine, seborrheic keratosis, vaccine adverse reaction, immune activation, autoimmune response