Treatment of psoriasis with etanercept in a patient with a history of primary B-cell lymphoma

Abstract

The use of immunobiologicals that suppress an overly active immune system in psoriasis carries with it the possibility of cancer development as a result of immunosuppression. Patients with a history of malignancy may be at risk for recurrence when treated with immunosuppressive agents. Moreover, autoimmune diseases, such as psoriasis, have been associated with an increased risk of lymphoma. Therefore, risk-benefit assessments must take into account the clinical severity and treatment of psoriasis. We describe a 59-year-old white man with a history of primary B-cell lymphoma, severe recalcitrant plaque-type psoriasis and psoriatic arthritis, who was started on etanercept for treatment of his psoriasis and psoriatic arthritis. The patient has a long history of remission of his lymphoma. After treatment, the patient experienced significant global improvement with essentially complete remission of the cutaneous lesions and arthritis, and had no recurrence of his lymphoma or other systemic complications while on etanercept after follow-up for > 3 years.