Severe relapse of generalized psoriasis in a young patient with a Löfgren syndrome history

Abstract

Psoriasis and sarcoidosis are two systemic inflammatory diseases characterized by elevated Th1 and Th17 lymphocyte activity and overlapping genetic components. Although psoriasis often accompanies known comorbidities, the simultaneous presence of acute sarcoidosis (Löfgren syndrome [LöS]) is uncommon. A 23-year-old Caucasian male patient with a history of mild psoriasis without relapse since childhood presented with generalized psoriatic plaques. In May 2020, he experienced symptoms compatible with LöS, which was followed by complete resolution after three months of systemic corticosteroid therapy. After one year of treatment with adalimumab, the Psoriasis Area and Severity Index (PASI) decreased from 25.3 to 4.2, while sarcoidosis remained stable. The common pathogenic mechanisms between psoriasis and sarcoidosis warrant further investigation. This case emphasizes the importance of vigilance for respiratory symptoms in psoriasis patients and the potential for psoriasis recurrence after sarcoidosis. Dermatologists need to be aware of these associations, promoting comprehensive management strategies for psoriatic patients with a history of sarcoidosis.