Plaquinol exacerba psoriasis

Hydroxychloroquine Effects on Psoriasis: A Systematic Review and a Cautionary Note for COVID-19 Treatment

Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• This systematic review of case studies and case series revealed 18 patients who had psoriasis-related complications due to hydroxychloroquine (HCQ). Of these, 50% (n=9) had de novo psoriasis induction, 27.8% (n=5) had exacerbation of existing psoriasis, and 22.2% (n=4) had a relapse of psoriasis after HCQ use. No pattern with regard to location or type (pustular, plaque, or inverse) of psoriasis was identified. Females represented 77.8% of the cases.

• With an increased use of HCQ for COVID-19 treatment, it is important to understand the impact of HCQ on common dermatologic conditions such as psoriasis. Current data suggest that HCQ may lead to induction, exacerbation, or relapse of psoriasis. Preliminary studies suggest that increased keratinization and IL-17 production may be possible mechanisms.

– InYoung Kim, MD, PhD

BACKGROUND

While evidence suggests that hydroxychloroquine (HCQ) may decrease the viral load in patients with a COVID-19 infection, a number of case reports indicate adverse dermatologic effects of this potential treatment.

OBJECTIVE

To conduct a systematic review of previously reported cases of psoriasis onset, exacerbation, or relapse after HCQ treatment.

METHODS

A comprehensive EMBASE and MEDLINE search of original studies examining adverse effects of HCQ treatment related to psoriasis was conducted. Participant demographics, and details of HCQ administration and psoriasis diagnosis were extracted from 15 articles representing 18 patients.

RESULTS

Females accounted for a significantly larger number of psoriatic cases compared to males and unreported sex (n=14, 77.8% vs. n=2, 11.1% vs n=2, 11.1% respectively). Additionally, 50% (n=9) of the cases did not have a history of psoriasis prior to taking HCQ. Of the 18 patients, 50.0% (n=9) experienced de novo psoriasis, 27.8% (n=5) experienced exacerbation of psoriatic symptoms and 22.2% (n=4) had a relapse of psoriasis after HCQ administration.

CONCLUSIONS

HCQ treatment may result in induction, exacerbation, or relapse of psoriasis. Monitoring for adverse effects of HCQ treatment is necessary, and clinical trials are essential in characterizing the safety profile of HCQ use in patients with a COVID-19 infection.

Journal of the American Academy of Dermatology

Hydroxychloroquine Effects on Psoriasis: A Systematic Review and a Cautionary Note for COVID-19 Treatment

J Am Acad Dermatol 2020 May 19;[EPub Ahead of Print], M Sachdeva, A Mufti, K Maliyar, Y Lytvyn, J Yeung

Sent from my iPhone

Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

Please excuse the shortness of this message, as it has been sent from
a mobile device.