Aphthous Stomatitis in a Man with Psoriatic Arthritis

Published:February 16, 2021DOI:
      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 A loss of effect had been suspected because of severe fatigue, and adalimumab had been replaced by secukinumab, an interleukin (IL)-17A inhibitor, 6 months before admission.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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        • Schreiber S
        • Colombel J-F
        • Feagan BG
        • et al.
        Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: a retrospective analysis of pooled data from 21 clinical trials.
        Ann Rheum Dis. 2019; 78: 473-479
        • Torres J
        • Mehandru S
        • Colombel JF
        • Peyrin-Biroulet L
        Crohn's disease.
        Lancet. 2017; 389: 1741-1755
        • Muhvić-Urek M
        • Tomac-Stojmenović M
        • Mijandrušić-Sinčić B
        Oral pathology in inflammatory bowel disease.
        World J Gastroenterol. 2016; 22: 5655-5667
        • Fries W
        • Belvedere A
        • Cappello M
        • Orlando A
        • Trifirò G
        Inflammatory bowel disease onset during secukinumab treatment: Real concern or just an expression of dysregulated immune response?.
        Clin Drug Investig. 2019; 39: 799-803
        • Hohenberger M
        • Cardwell LA
        • Oussedik E
        • Feldman SR
        Interleukin-17 inhibition: role in psoriasis and inflammatory bowel disease.
        J Dermatolog Treat. 2018; 29: 13-18
        • Gracey E
        • Vereecke L
        • McGovern D
        • et al.
        Revisiting the gut-joint axis: links between gut inflammation and spondyloarthritis.
        Nat Rev Rheumatol. 2020; 16: 415-433
        • Hueber W
        • Sands BE
        • Lewitzky S
        • et al.
        Secukinumab, a human anti-IL-17A monoclonal antibody, for moderate to severe Crohn's disease: unexpected results of a randomised, double-blind placebo-controlled trial.
        Gut. 2012; 61: 1693-1700