Paradox psoriasis after tnf alpha inhibitor (bechterew desease)
Hello Everyone!
I have ankylosis spondylitis. I had my first 300 mg Cosentyx shot next week will be the 4th of the loading dose.. I got Infliximab (Remicade, Zessly infusion), and I was 100 % symptom free and almost inflammation free about 2,5 years. 2 weeks after the 2nd mrna covid vaccine pimples and pustules have spread all over my body, especially on the chest, back, and shoulders. The CRP levels and my eye is flared up. Me and my dermatologist said its ekzema and maybe folliculitis or body acne. Symptoms doesnt go away for a year now, and my rheumatologist changed my completely working infliximab to Cosentyx, saying the pimples caused by infliximab after the vaccine, and after I went through covid. My T cell activity is being a high level, and is in connection with tnf alpha blockers. So my diagnosis also changed to Arthropatrial psoriartyca. (paradox psoriasis) Studies said people using infliximab are related to psoriasis activities after a long term use, if the immun system tiggered by sg like covid.
Has anyone this kind of specific story? After the second loading dose, new pusular pimples broken out, and it really hurts. BUT my older pimples has started to dissappear..
Can it be an allergic reaction? Or just my tnf alpha , that I got for the last time at 2.5 months ago, are still in my system..
Thank you.
Hi
. We are not medical experts, so we can't guess at what exactly is going on, but, hopefully, someone who has had a similar experience will chime in here. The Covid vaccines can put a lot of stress on your body as your body builds up antibodies to protect you and that stress can sometimes make PsA symptoms worse. Along with that, you were receiving infliximab, which can cause worsening skin symptoms. So it's possible the two together were too much for your body. I hope the current outbreak begins to fade as the Cosentyx builds up in your system and that you get some relief. Keep us posted if you feel comfortable doing so. Thinking of you. - Lori (Team Member) 
Adam, the word paradox in your post caught my attention. If I read post correctly, a biologic along with the COVID vaccine changed your disease.
I had something similar happen although it was prior to getting the vaccine.
I was strongly sero positive for RA for years and on Humira.
In the spring of 2020, I developed a very bad case of scalp psoriasis. Labs revealed that I was HBLA 27 positive and no longer RA positive. I am now diagnosed with PsA with no further skin involvement.
My rheumatologist calls this transition "the great paradox". Did years of Humira push me here or was my wonky immune system headed here on it's own? I have relatives with scalp psoriasis, including my mother, and 2 male cousins with axial spondylarthritis.
This was initially frustrating because I was used to RA. That's the "beastie" that I knew.
Finding this community has been a life saver for me. I have learned a lot about PsA and the folks here are supportive.I had ended the loading dose of Cosentyx, it appears that my bumps are going to heal slowly, but my CRP level increased from 11 to 35 🙁 I am afraid that my doctor will not gonne be like this. My reuma issue hasnt come worse fortunately, I feel it has to be good for me, but CRP maybe increased because of my big numbers of pimples did this.
Before my PsA diagnosis 01/2021, I only rarely had spots of psoriasis show up. Every now & then it would be a plaque type, but more common was inverse. Last summer, I did both Humira & Enbrel, followed by Taltz at the new year. I suddenly had breakouts of skin issues everywhere; paradoxical side effect. A lot was a pre-plaque type (on my belly, legs, arms), but my face & other sensitive places became ravaged by inverse. I've been on Cosentyx since spring, and the plaque-ish stuff is gone, but I'm still having a tough time w/my eyelids, ears, & around nostrils. My rheumatologist said Cosentyx should be better for the skinesions, but my face is still struggling.
