Teaching NeuroImages: Interferon-induced psoriasis flare in a multiple sclerosis case remits with dimethyl fumarate

A 26-year-old woman with a history of psoriasis diagnosed with relapsing-remitting multiple sclerosis (Expanded Disability Status Scale score 1) received SC interferon β-1a as first-line treatment. Interferon was discontinued 4 months later, following a dramatic psoriasis flare with plaques in upper and lower extremities (figure, A–C) and manifestation of Koebner phenomenon along abdominal injection sites (figure, C). Switch to oral dimethyl fumarate (DMF) resulted in complete remission within 14 months (figure, D–F), and the patient remained relapse-free for the last 3 years under DMF treatment. Our case is consistent with the association of multiple sclerosis with psoriasis1 and the overlapping efficacy of fumaric acid esters in both conditions.2

Source: Neurology - October 9, 2017 Category: Neurology Authors: Tsivgoulis, G., Papadimitropoulos, G. N., Katsanos, A. H., Zompola, C., Safouris, A., Kargiotis, O., Voumvourakis, K. Tags: Autoimmune diseases, Multiple sclerosis RESIDENT AND FELLOW SECTION Source Type: research