Dear Editor,
A 20‐year‐old woman presented with scaly, itchy rashes on her scalp and face for 1 month. A month prior, the patient presented with scattered papules on her face. She was diagnosed with verruca plana and treated with topical recombinant human interferon α2β gel. The papules gradually increased and fused, with yellow crusts on the surface and itching. Physical examination showed yellowish thick crusted plaques with erythema on the scalp and face (Figure 1). Dermoscopic examination of the facial lesions revealed regularly distributed ring or hairpin‐like vessels on an erythaematous background (Figure 2). Histopathology revealed parakeratosis, disappearance of the granular layer, extension of the epidermal protrusion, and dilated blood vessels surrounded by inflammatory cells in the dermal papillary layer (Figure 3). Based on the combined clinical presentation and dermoscopic and histopathological examinations, the patient was diagnosed with psoriasis. We treated her with compound glycyrrhizin injection 60 mL a day, oral total glucosides of paeony capsules 1800 mg and glucosidorum tripterygll totorum tablets 60 mg per day, topical triamcinolone acetonide and econazole nitrate cream and calcipotriol and betamethasone dipropionate gel once daily. One month later, the skin lesions had improved (Figure 4).
FIGURE 1.
Clinical manifestations of the patient before treatment.
FIGURE 2.
Dermoscopic findings of the facial lesions showed distributed ring or hairpin‐like vessels.
FIGURE 3.
Tissue biopsy revealed parakeratosis, disappearance of the granular layer, extension of the epidermal protrusion (HE × 400).
FIGURE 4.
One month after treatment.
Psoriasis is a common chronic inflammatory disease in dermatology. Types of psoriasis include guttate psoriasis, plaque psoriasis, red skin psoriasis, and pustular psoriasis. The aetiology of psoriasis is complex and includes psoriatic autoantigens, the innate and adaptive immune systems, psoriatic‐related susceptibility genes, and environmental factors. 1 IFN can be divided into type I IFN (IFN‐α and IFN‐β), type II IFN (IFN‐γ) and type III IFN (IFN‐λ). Type I and type III IFNs are secreted by several cell types, 2 while type II IFN is released by activated T cells and NK cells. 3 Type I interferons have been shown to play a role in the pathogenesis of psoriasis, in addition to being key antiviral agents. Wu T et.al. investigated the effects of secukinumab treatment for psoriasis on different functional cytokines and inflammatory mediators in patients’ serum, confirms role of interferon in pathogenesis of psoriasis. 4 Whereas, interferon is not specific to psoriasis also plays role invariety of skin inflammatory diseases such as atopic dermatitis. 5
In this case, topical interferon resulted in a rapid increase and aggravation of the skin lesions, which presented as psoriasis. This suggests that psoriasis caused by interferon is not limited to systematic medication. Overall, psoriatic skin lesions may mimic other skin diseases, suggesting the importance of dermoscopic and histopathological examinations to avoid misdiagnosis.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflicts of interest.
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
REFERENCES
- 1. Hawkes JE, Chan TC, Krueger JG. Psoriasis pathogenesis and the development of novel targeted immune therapies. J Allergy Clin Immunol. 2017; 140(3):645‐653.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Mora‐Arias T, Amezcua‐Guerra LM. Type III Interferons (Lambda Interferons) in Rheumatic Autoimmune Diseases. Arch Immunol Ther Exp (Warsz). 2020; 68(1):1. [DOI] [PubMed] [Google Scholar]
- 3. Taniguchi T, Ogasawara K, Takaoka A, et al. IRF family of transcription factors as regulators of host defense. Annu Rev Immunol. 2001; 19:623‐655. [DOI] [PubMed] [Google Scholar]
- 4. Wu T, Qiao Z, Lin J, et al. The effect of secukinumab treatment for psoriasis on serum cytokines and correlation with disease severity. Skin Res Technol. 2023; 29(7):e13405. [DOI] [PMC free article] [PubMed] [Google Scholar] [Retracted]
- 5. Lee KH, Kim JD, Jeong DH, et al. Development of a novel microneedle platform for biomarker assessment of atopic dermatitis patients. Skin Res Technol. 2023;29(7):e13413. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.