Plaque psoriasis and psoriatic arthritis associated with uveitis and cystoid macular edema treated with adalimumab: A case report and literature review
World Dermatologist Summit and Skin Care Expo
October 30-31, 2017 | Toronto, Canada
University of Warmia and Mazury in Olsztyn, Poland
Keynote : Dermatol Res Skin Care
Introduction: Psoriatic patients, especially with psoriatic arthritis (PsA), are more prone to metabolic disorders and involving the eyes. Aim: The aim of this study was presentation adalimumab efficacy of several aspects of psoriasis and its comorbidities. Material & Methods: We present a 48-year-old male patient with severe plaque psoriasis and PsA who developed uveitis with cystoid macular oedema in the right eye. The patient was obese although bariatric surgery eight years earlier produced some weight loss with remission of diabetes and hypertension. Results & Discussion: The patient had been previously treated with systemic treatment with no improvement in PsA symptoms and skin lesions but rapidly responded to adalimumab. At week 8, the patient achieved the PASI 75, with no joint pain and normal macular architecture. At week 16, there was an incident of atrial fibrillation followed by a transient ischaemic attack (TIA). The TIA subsided after intravenous fluids and antithrombotic treatment although acute urticaria developed after the first dose of acetylsalicylic acid. Adalimumab treatment was not stopped and the patient’s condition continued to improve. Conclusions: After careful consideration of the patient’s underlying and comorbid conditions and previous treatment failures, adalimumab was instituted and continued since its efficacy in psoriasis and PsA is well-documented; obesity is not thought to affect its effectiveness; inuveitis adalimumab acts quickly and induces long-term remission and a significant improvement of hemostasis and fibrynolytic balance has been observed in patients on TNF-α inhibitors and adalimumab could be continued after the TIA.
Agnieszka Owczarczyk-Saczonek is Assistant Professor of the Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology at The University of Warmia and Mazury in Olsztyn. She was appointed as the Consultant in dermatology and veneorogy of Warmian-Masurian Voivodeship in 2013. Moreover she is a Member of the Polish Society of Dermatology, a Member of the Association of Aesthetic Dermatology, and a Member of the European Academy of Dermatology and Venereology.