A case of concomitant hidradenitis suppurativa and psoriasis successfully treated with guselkumab in a patient with Down syndrome

In this case report, we present a 29-year-old patient with Down syndrome (DS) who manifested both psoriasis and hidradenitis suppurativa (HS) concurrently. The utilization of guselkumab, an interleukin 23 p19 subunit inhibitor that is approved for moderate to severe psoriasis vulgaris, resulted in significant improvement in symptoms for both conditions following the initial administration. The patient achieved a psoriasis area and severity index 90 response with significant amelioration of psoriatic plaques. Simultaneously, more than 50% improvement in abscess and inflammatory nodules secondary to HS was observed 4 weeks after the start of guselkumab therapy, resulting in a HiSCR score achievement. Throughout the 52-week follow-up, there were no observed exacerbations of symptoms or adverse effects. This case highlights the potential benefit of guselkumab in the simultaneous treatment of HS and psoriasis, and suggests that guselkumab is an effective and safe biologic agent of choice in individuals with DS, where the prevalence of both these diseases is increased, and treatment adherence may pose additional challenges compared to the normal population.