Systemic Treatment Considerations for Psoriasis in Alpha-Gal Syndrome: A Case Report and Ingredient Review

Background: Psoriasis is a chronic skin condition characterized by an overactive immune system, leading to increased keratinocyte proliferation and angiogenesis. Treatment ranges from topical solutions to systemic therapy and lastly, biologics. However, the latter options are typically manufactured with mammalian-derived ingredients. Alpha-gal syndrome (AGS) is an acquired IgE-mediated hypersensitivity reaction to galactose-alpha-1,3-galactose, an enzyme required for digesting carbohydrates in mammalian products. In addition to dietary avoidance of mammalian products, patients with AGS may need to avoid certain medications due to their formulations. Case Presentation: We present a case of a 53-year-old female with a severe alpha-gal allergy evaluated in the Dermatology clinic during a psoriasis flare, where management and treatment were complicated by the patient’s need for mammalian-free derivatives. Discussion: Patients with AGS face many barriers when it comes to managing their autoimmune conditions due to lack of ingredient transparency and mammalian derived vehicles. The development of mammalian-free formulations is urgently needed to improve quality of life in patients with severe autoimmune conditions and concurrent alpha-gal syndrome. Conclusion: This case underscores the importance of identifying effective mammalian-free alternatives while highlighting the need for increased awareness among clinicians and pharmaceutical manufacturers.