Ocrelizumab-induced Psoriasis in A Patient with Relapsing-Remitting Multiple Sclerosis

Abstract
Background: Ocrelizumab is widely used as a Disease Modifying Drug (DMD) in Multiple sclerosis. The complete side effects are yet not known. Materials and Methods: We describe a 34-year-old female with longstanding relapsing-remitting Multiple Sclerosis for whom Ocrelizumab was started as an escalation therapy. She reported severe itchy and patchy lesions two months after the first full dose of Ocrelizumab. Pathohistological findings revealed the diagnosis of guttate psoriasis. Psoriasis continued to flare against treatment with topical steroids, and UV therapy and progressed to developed arthritis psoriasis. Results: Treatment escalated to an IL-17 antagonist (Secukinumab), with a favorable outcome. Ocrelizumab was discontinued. After one year of follow-up, the patient remained stable from an MS standpoint. Conclusion: This is the third report showing the possible cutaneous side effect of Ocrelizumab.