Azevedo, A.Torres, T.2019-07-182019-07-182018-09-10Dermatol Online J. 2018 Sep 10;24(9). pii: 13030/qt2qn1p4bz1087-2108http://hdl.handle.net/10400.16/2280We report a patient with severe psoriasis who failed to respond to phototherapy, conventional systemic treatment and four biologic agents (etanercept, ustekinumab, adalimumab and secukinumab). Combination of a higher-dose secukinumab regimen with phototherapy had no success. Remarkably, ixekizumab, an IL-17A inhibitor, provided almost complete psoriasis clearance after 24 weeks of treatment. The reason for the success of ixekizumab after the failure to respond to a biologic with same mechanism of action is still unknown. Interestingly, failure of secukinumab does not preclude future therapeutic success with a second IL-17A-inhibitor.porjournal article