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This case report documents unexpected onset of psoriatic dermatitis in a 16-year-old male with polyarticular juvenile idiopathic arthritis after tocilizumab. No prior personal or family psoriasis history was present, suggesting a paradoxical reaction to IL-6 inhibition. Treatment used topical corticosteroids and vitamin D analogs, with consideration of dose adjustment or switching to an alternative biologic, emphasizing individualized management.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/tocilizumab-induced-psoriatic-dermatitis-in-polyarticular-juvenile-idiopathic-arthritis-a-rare-case-report/456262/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/tocilizumab-induced-psoriatic-dermatitis-in-polyarticular-juvenile-idiopathic-arthritis-a-rare-case-report/456262.png","ImageObject",300,407,{"name":92,"@type":93},"Aldword","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",18,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What medication is linked to the onset of psoriatic dermatitis in this case?","Question",{"text":113,"@type":114},"The report describes psoriatic dermatitis emerging after treatment with tocilizumab, an IL-6 receptor inhibitor.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How did the patient present initially, and what was notable about the history?",{"text":118,"@type":114},"A 16-year-old male presented with recurrent bilateral knee pain, morning stiffness, and functional limitations, with no prior personal or family history of psoriasis or related dermatologic conditions.",{"name":120,"@type":111,"acceptedAnswer":121},"What management approach was considered for the unexpected dermatologic adverse effect?",{"text":122,"@type":114},"Management included topical corticosteroids and vitamin D analogs, with consideration of dose adjustment or transition to an alternative biologic therapy.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},456262,1790794159,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52,"preview_page_count":4},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Tocilizumab-induced psoriatic dermatitis in polyarticular juvenile idiopathic arthritis: A rare case report  \nSAGE Open Medical Case Reports JCMS Case Reports Volume 14: 1–4 © The Author(s) 2026 Article reuse guidelines:  \n[sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/2050313X251408894](DOI: 10.1177/2050313X251408894)[ ](DOI: 10.1177/2050313X251408894)[journals.sagepub.com/home/sco](journals.sagepub.com/home/sco)  \nRahul Yedpallikar Rajesh 1, Pavisankar Biju Seena2, Eka Nakhutsrishvili3, Tejasri Akkineni4, Aasim Akthar Ahmed 1, Tarun Kumar Suvvari5,  \nVimal Thomas 1,5 and Tejinder Singh5,6  \nAbstract  \nPsoriasis is an immune-mediated inflammatory disorder with a strong genetic predisposition. However, in some cases, it canemerge as an adverse effect of biologic therapy, particularly interleukin-6 inhibitors such as tocilizumab. This case report describes the unexpected onset of psoriatic dermatitis in a 16-year-old male diagnosed with polyarticular juvenile idiopathic arthritis following treatment with tocilizumab. The patient had no prior personal or family history of psoriasis, highlighting a potential paradoxical reaction to interleukin-6 inhibition. Management strategies included topical corticosteroids and vitamin D analogs, with consideration of dose adjustment or transition to an alternative biologic therapy. This case highlights the importance of recognizing dermatologic adverse effects associated with interleukin-6 inhibitors and emphasizes the need for individualized treatment strategies in juvenile idiopathic arthritis patients receiving biologic therapy.  \nKeywords  \npsoriasis, juvenile idiopathic arthritis, psoriatic dermatitis, tocilizumab, case report  \nReceived: 22 May 2025; accepted: 19 August 2025  \nIntroduction  \nJuvenile idiopathic arthritis (JIA) is the most prevalent chronic inflammatory arthritis in children and adolescents, characterized by persistent joint inflammation that can lead to long-term disability.1 Among the various subtypes, polyarticular JIA involves multiple joints and often necessitates aggressive treatment with disease-modifying antirheumatic drugs and biologic agents to achieve disease control. Tocilizumab (TCZ), a monoclonal antibody targeting the interleukin-6 (IL-6) receptor, has demonstrated significant efficacy in managing systemic and polyarticular JIA.2 However, biologic therapies, including IL-6 and tumor necrosis factor-α (TNF-α) inhibitors, have been associated with paradoxical immune-mediated adverse effects, including psoriasiform skin eruptions.2–4  \nPsoriasis and psoriasiform dermatitis are well-documented side effects ofTNF-α inhibitors, but their occurrence with IL-6 blockade remains rare and poorly understood. The underlying mechanism is hypothesized to involve immune dysregulation, where IL-6 inhibition may disrupt cytokine  \nbalance, leading to unopposed IL-17 activity and the emergence of psoriatic lesions.3,4 In this report, we describe a unique case of TCZ-induced psoriatic dermatitis in a JIA patient without a prior history of psoriasis, emphasizing the importance of early recognition and appropriate management of this unexpected adverse effect.  \n1 Tbilisi State Medical University, Georgia 2Government Medical College Manjeri, India  \n3G. Zhvania Academic Clinic of Pediatrics, Tbilisi State Medical University, Georgia  \n4Apollo Institute of Medical Sciences and Research (AIMSR), Chittoor, India  \n5Squad Medicine and Research (SMR), Amadalavalasa, India 6Odessa National Medical University, Ukraine  \nCorresponding authors:  \nVimal Thomas, Tbilisi State Medical University, 33 Avenue Vazha Pshavela, Tbilisi 0186, Georgia.  \nEmail: [drvimal4u@gmail.com](drvimal4u@gmail.com)  \nTejinder Singh, Odessa National Medical University, Odessa 65082, Ukraine.  \nEmail: [tejindersingh.md@gmail.com](tejindersingh.md@gmail.com)  \nCreative Commons Non Commercial CC BY-NC: This article is distributed under the te","cbCaiokPvSbLVrHm","https://ap.wps.com/l/cbCaiokPvSbLVrHm","pdf",645131,"English","# Abstract\n# Introduction\n# Case presentation\n## Diagnostic workup\n## Clinical findings","[{\"question\":\"What medication is linked to the onset of psoriatic dermatitis in this case?\",\"answer\":\"The report describes psoriatic dermatitis emerging after treatment with tocilizumab, an IL-6 receptor inhibitor.\"},{\"question\":\"How did the patient present initially, and what was notable about the history?\",\"answer\":\"A 16-year-old male presented with recurrent bilateral knee pain, morning stiffness, and functional limitations, with no prior personal or family history of psoriasis or related dermatologic conditions.\"},{\"question\":\"What management approach was considered for the unexpected dermatologic adverse effect?\",\"answer\":\"Management included topical corticosteroids and vitamin D analogs, with consideration of dose adjustment or transition to an alternative biologic therapy.\"}]","Tocilizumab-induced psoriatic dermatitis in polyarticular juvenile idiopathic arthritis: A rare case report | PDF",1790745433]