title: Exacerbation of paranoid schizophrenia in a psoriatic patient after treatment with cyclosporine A, but not with etanercept.
abstract: Psoriasis may be frequently associated with psychiatric diseases. We present a 44-year-old man undergoing cyclosporine therapy for treatment of generalized plaque psoriasis which exacerbated his symptoms of paranoid schizophrenia, and disappeared a few days after discontinuation of cyclosporine. Replacement therapy with etanercept achieved clinical remission of psoriasis without any psychiatric side effects. Systemic medications, such as cyclosporine and etanercept, induce modifications of the cytokine network. This is pathogenetically significant in both psoriasis and psychiatric disorders. This case report suggests that dermatologists need to become more familiar with the risk-benefit of drug-induced cytokines dysregulation in psoriatic patients with comorbid psychiatric disorders.
authors.affiliation: Section of Dermatology, Department of Surgery, University of Parma, Parma, Italy. sergio.dinuzzo@unipr.it
authors.forename: Sergio
authors.initials: S
authors.lastname: Di Nuzzo
authors.forename: Martina
authors.initials: M
authors.lastname: Zanni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Panfilis
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D011565:Psoriasis / Q000150:complications* / Q000188:drug therapy; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012563:Schizophrenia, Paranoid / Q000139:chemically induced* / Q000150:complications
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D016572:Cyclosporine; D000068800:Etanercept