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Aphthous Stomatitis in a Man with Psoriatic Arthritis

Published:February 16, 2021DOI:https://doi.org/10.1016/j.amjmed.2021.01.018
      A 57-year-old man was admitted to the Department of Internal Medicine for a painful aphthous stomatitis, which had been present for 2 weeks and had not resolved under antibiotic treatment (amoxicillin-clavulanic acid). He had a medical history of psoriatic arthritis, successfully treated for 5 years with adalimumab, an anti-tumor necrosis factor agent. A loss of effect had been suspected because of severe fatigue, and adalimumab had been replaced by secukinumab, an interleukin (IL)-17A inhibitor, 6 months before admission. He was also receiving clopidogrel and flecainide for atrial fibrillation, and oral potassium for chronic hypokalemia. He had a family history (an uncle and a cousin) of Crohn's disease.
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