A case of eczematoid eruption following IL-23 inhibitor: improvement with IL-17 inhibitor switching and cyclosporine combination

Psoriasis is a chronic inflammatory skin disease, and in severe cases, use of biologics has become more prevalent.Common side effeinclude infections and gastrointestinal symptoms.However, in some patients, eczematous-type rashes can develop, which may not restreatments like steroid, potentially requiring discontinuation or switching of biologic agent.A 51-year-old male who was diagnosed withdid not respond to treatment visited our hospital.He had administration of Guselkumab, but developed a nummular eczematous eruptcorticosteroid0 treatment, rash did not improve, so the biologic agent was switched to Risankizumab, and concomitant oral cyclosporinand resulting in improvement.However, eczematous lesions recurred, so he continued cyclosporine while being switched to Secukinumaintaining improved condition.Herein, we report a case of a nummular eczematoid eruption in a patient with IL-23 inhibitor, which imswitching to IL-17 inhibitor and adding cyclosporine.