# Management of Drug-Induced Psoriasis With Secukinumab in a Patient With Schizoaffective Disorder: A Case Report

## TL;DR

A patient with schizoaffective disorder developed psoriasis after starting lithium, which improved after switching to valproate and using secukinumab.

## Contribution

This case report highlights drug-induced psoriasis and the benefits of a tailored treatment approach for comorbid psychiatric and dermatologic conditions.

## Key findings

- Lithium-induced psoriasis flare worsened the patient's mental health.
- Switching to valproate and adding secukinumab improved both psoriasis and psychiatric symptoms.
- The case emphasizes the importance of recognizing drug-induced psoriasis and its impact on mental health.

## Abstract

Psoriasis is a chronic inflammatory systemic disorder often associated with psychiatric comorbidities such as depression and anxiety. This case report describes a 25-year-old man with schizoaffective disorder, bipolar type, whose suicidal ideation was worsened by a severe psoriasis flare that was induced by the initiation of lithium for psychiatric management. Lithium was switched to valproate, and treatment with secukinumab, an IL-17A inhibitor, was initiated, resulting in significant improvement in both psoriasis and mental health. This case highlights the phenomenon of drug-induced psoriasis, emphasizing the need for a high index of suspicion and careful review of past medical history. It underscores the reciprocal relationship between psoriasis and psychiatric comorbidities, advocating for a tailored approach to treating both conditions to achieve optimal outcomes.