ArticleSAGE open medical case reports2025
Biologic and small molecule therapies for psoriasis in individuals with Down syndrome: Two cases and a systematic review.
Article in SAGE open medical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Down syndrome (DS), also known as trisomy 21, is a genetic condition linked to a higher prevalence of skin disorders, including psoriasis, which affects up to 8% of individuals. DS patients with psoriasis present unique management considerations, including a theoretical increased risk of infectious complications with immunosuppressive therapies. This report includes two cases and a systematic review summarizing available evidence on psoriasis characteristics and treatment outcomes in individuals with DS. We report two DS patients with psoriasis demonstrating variable therapeutic responses: one controlled with acitretin and another requiring secukinumab after multiple treatment failures. To contextualize these findings, we conducted a systematic review following PRISMA guidelines, identifying 10 studies comprising 37 DS patients with psoriasis. Methotrexate was the most frequently failed therapy. Biologics targeting IL-17 and IL-23 pathways achieved the highest rates of complete resolution. These findings reflect Th1/Th17-driven inflammation in DS and highlight the need for individualized, pathway-specific management strategies.
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