New Skin Lesions After Vaccination Reported in Psoriasis Patient on Risankizumab

The case, posted by the NEJM on social media, centres on a patient with a history of moderate-to-severe plaque psoriasis (a chronic skin condition causing raised, scaly patches) whose symptoms had been well controlled. He had been taking risankizumab — a biologic treatment that works by blocking a protein called interleukin-23, which drives skin inflammation — for long enough that his condition was considered to be in remission. Two weeks after his first vaccination, new lesions appeared and he attended a dermatology clinic.

The NEJM’s report does not establish that the vaccination caused the flare. The timing — two weeks between the jab and the appearance of new lesions — is what prompted clinical attention and the write-up, according to the journal.

Biologic drugs such as risankizumab are used when standard psoriasis treatments haven’t worked well enough. They target specific parts of the immune system, which is also the system that responds to vaccines. That interaction is an active area of medical research, though the NEJM case report represents a single patient’s experience and cannot on its own indicate how common such a reaction might be.

Anyone on biologic therapy for psoriasis or another condition who notices new or worsening skin changes after a vaccination should contact their GP or dermatology team rather than stopping their medication without advice.

NHS 111 is available by phone or online for general health queries. For urgent skin concerns, a GP can refer patients to dermatology services through NHS Kent and Medway.

Key information

• Do not stop biologic medication without speaking to your GP or specialist first
• Contact NHS 111 if you have health concerns and cannot reach your GP
• In a medical emergency, call 999