Supplementary Material for: Emergence of Vitiligo during Treatment with Risankizumab-rzaa for Plaque Psoriasis: A Case Report

We present a case of de novo vitiligo in a patient being treated with risankizumab-rzaa (Skyrizi) for plaque psoriasis. Our patient had extensive plaque psoriasis affecting his trunk, upper extremities, and scalp, encompassing 30% of his total body surface area (TBSA). He was treated with risankizumab-rzaa, an IL-23 inhibitor, with significant improvement of his psoriasis and residual hyperpigmented, post-inflammatory patches. In addition, he developed new-onset vitiligo, for which he declined treatment and was continued on risankizumab-rzaa. On subsequent follow-up over a year later, there were extensive areas of vitiligo now with a trichrome pattern suggestive of active vitiligo. To our knowledge, no cases of de novo vitiligo associated with risankizumab-rzaa have been reported in the literature, and our patient may represent the first reported case. The role of IL-23 remains unclear, and our case represents the importance of further research to better elucidate IL-23’s role in vitiligo.