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.

我们报告1例接受瑞莎珠单抗-rzaa（risankizumab-rzaa，商品名Skyrizi）治疗斑块状银屑病的患者，该患者出现新发白癜风。该患者存在累及躯干、上肢及头皮的广泛性斑块状银屑病，受累体表面积（TBSA）达30%。予患者白细胞介素-23抑制剂（IL-23 inhibitor）瑞莎珠单抗-rzaa治疗后，其银屑病症状显著改善，遗留炎症后色素沉着斑。与此同时，患者出现新发白癜风，其拒绝接受针对性治疗，遂继续原瑞莎珠单抗-rzaa治疗方案。随访逾1年后，患者出现广泛性白癜风皮损，皮损呈现三色征，提示白癜风处于活动期。据我们所知，目前尚无文献报道与瑞莎珠单抗-rzaa相关的新发白癜风病例，本病例或为全球首例报道。白细胞介素-23在白癜风发病中的具体作用仍未明确，本病例凸显了开展进一步研究以阐明IL-23在白癜风发病机制中作用的必要性。