Psoriasis in Down Syndrome: A Literature Review of Pathophysiological Links and a Rare Pediatric Case of Erythrodermic Psoriasis Managed with Ixekizumab

Down syndrome (DS) is associated with various dermatological conditions, including xerosis, seborrheic dermatitis, folliculitis, alopecia areata, and, rarely, psoriasis. The pathogenesis of psoriasis in DS patients may be influenced by immune system dysregulation, a characteristic of this syndrome. Hyperactive interferon system and raised Th1 cells, the alteration of cyclic nucleotides cGMP, cAMP, a rise in the serum level of gamma-delta T-cells, less AIRE gene expression, leading to autoreactive T-cells that recognize cytokeratin 17, and defective regulatory T cells in DS may have a role in psoriasis pathogenesis. Here, we report a rare case of unstable psoriasis in a 15-year-old boy treated with ixekizumab.