• Yu Xiao, Shanshan Peng, Xiangjun Li, Tianyi Mao, Muping Fang, Youhong Hu, and Wenzheng Ye.
• The Central Hospital of Xiaogan, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Hubei, China.
• Medicine (Baltimore). 2023 Feb 10; 102 (6): e32844e32844.

RationaleEczematous eruption is an increasingly recognized form of drug-related eruption, typically reported in association with interleukin 17 (IL-17)A inhibitors. However, severe paradoxical eczematous eruption due to IL-17A inhibitors has been rarely reported. Herein, we reported a case of a man with severe psoriasis with erythematous scaly plaques on the scalp, trunk, and arms and legs after the administration of secukinumab was initiated.Patient ConcernsWe reported a case of a 20-year-old man with severe psoriasis with erythematous scaly plaques on the scalp, trunk, and arms and legs after the administration of secukinumab was initiated. A skin biopsy was performed. It revealed spongiotic dermatitis consistent with eczematous reaction. Direct and indirect immunofluorescence assays were negative.DiagnosesHe was diagnosed with eczematous eruption.InterventionsDiscontinuation of secukinumab and administration of cyclosporine and prednisone were considered.OutcomesSignificant improvement was observed, with no adverse events.ConclusionOur case shows that eczematous eruption can paradoxically occur in patients on IL-17A inhibitors and this report is expected to increase awareness of the rising number of cutaneous eruptions related to biological agents.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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