PLAQUE PSORIASIS IN A PATIENT WITH DOWN SYNDROME - POTENTIAL COMMON PATHOPHYSIOLOGY AND TREATMENT DIFFICULTY

  • Catarina Araújo Interna do Internato Complementar de Dermatologia e Venereologia/Resident, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Hospital de Braga, Sete Fontes – São Victor, Braga, Portugal
  • Cristina Resende Interna do Internato Complementar de Dermatologia e Venereologia/Resident, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Hospital de Braga, Sete Fontes – São Victor, Braga, Portugal
  • Ana Paula Vieira Assistente Hospitalar Graduado de Dermatologia e Venereologia/Consultant, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Hospital de Braga, Sete Fontes – São Victor, Braga, Portugal
  • José Carlos Fernandes Assistente Hospitalar Graduado de Dermatologia e Venereologia/Consultant, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Hospital de Braga, Sete Fontes – São Victor, Braga, Portugal
  • Celeste Brito Chefe de Serviço, Directora do Serviço de Dermatologia e Venereologia/Consultant Chief, Head of Department of Dermatology and Venereology Serviço de Dermatologia e Venereologia, Hospital de Braga, Sete Fontes – São Victor, Braga, Portugal
DOI: https://doi.org/10.29021/spdv.73.1.357
Keywords: Antibodies, monoclonal, Down syndrome, Psoriasis

Abstract

Introduction: Psoriasis occurs in up to 8% of patients with Down syndrome and, although poorly characterized, appears to be correlated with immune imbalance in cells Th1 and biochemical changes of cyclic nucleotides.

Case report: Female patient, 38 years old, with Down syndrome and psoriasis (initial PASI 30) since 18 years. Initially treated with cyclosporine and methotrexate and subsequently with etanercept, adalimumab and ustecinumab because of progressive loss of response (current PASI 10).

Conclusion: We describe this case for the poor response to treatment including various biological agents. Potential poor adherence to therapy and immune dysfunction may limit the therapeutic options.

Downloads

Download data is not yet available.

References

Carter M, Jegasothy BV. Alopecia areata and Down syndrome. Arch Dermatol. 1976; 112:1397-9.

Polenghi MM, Plattoni F, Orsini GB, et al. Dermatologic disorders in Down syndrome. Am J Med Genet 1990; 7(suppl): 324.

Madan V. Dermatological manifestations of Down’s syndrome. Clin Exp Dermatol. 2006; 31:623-9.

Alcaide AJ. Safety of etanercept therapy in a patient with psoriasis, Down’s syndrome and concomitant hepatitis C virus infection. J Eur Acad Dermatol Venereol. 2008; 22:1514-6.

Fargnoli MC. Psoriasis, Kaposi’s sarcoma and Hodgkin’s disease in a patient with Down’s syndrome. Dermatology. 2004; 209:158-9.

Mariyath OR. Unstable Psoriasis in Down’s Syndrome. Indian J Dermatol Venerol Leprol. 2003; 69:61-3.

Marmon S, Souza A, Strober B. Psoriasis and Down syndrome: A report of three cases and a potential pathophysiologic link. Dermatol Online J. 2012; 18(6):13.

Ihnat Dk, Simpson GM, Conard K, Scott CI, Singsen BH. Inflammatory arthropathies in children with chromosomal abnormalities. J Rheumatol.1993; 20:742-6.

Maroun LE. Interferon action and chromosome 21 trisomy (Down syndrome): 15 years later. J Theor Biol. 1996; 181:41-6.

Torre D. Serum levels of gamma interferon in patients with Down’s syndrome. Infection. 2005; 23(1):66-7.

Maroun LE. Interferon effect on ribosomal ribonucleic acid related to chromosome 21 ploidy. Biochem J. 1979; 179: 221-5.

Karlsson JO, Sjostedt A, Wahlstrom J, Axelsson KL, Andersson RG. Cyclic guanosine monophosphate metabolism in human amnion cells trisomic for chromosome 21. Biol Neonate. 1990; 57:343-8.

Talamonti M, Galluzzo M, Chiricozzi A, Teoli M, Bavetta M, Costanzo A et al. Ustekinumab for treatment of plaque psoriasis in a patient with Down syndrome. J Drugs Dermatol. 2012; 11(8):1000-2.

Published
2015-06-06
How to Cite
Araújo, C., Resende, C., Vieira, A. P., Fernandes, J. C., & Brito, C. (2015). PLAQUE PSORIASIS IN A PATIENT WITH DOWN SYNDROME - POTENTIAL COMMON PATHOPHYSIOLOGY AND TREATMENT DIFFICULTY. Journal of the Portuguese Society of Dermatology and Venereology, 73(1), 147-150. https://doi.org/10.29021/spdv.73.1.357
Issue
Vol 73 No 1 (2015): Janeiro - Março
Section
Case Reports

All articles in this journal are Open Access under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).

Most read articles by the same author(s)