Tirzepatide Linked to Psoriasis Flare in Patient with Remission History

Tirzepatide is a novel dual GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) receptor agonist, highly effective for managing type 2 diabetes and obesity. While its metabolic benefits are well-established, the full spectrum of its dermatological side effects, particularly in individuals with pre-existing autoimmune skin conditions, remains less understood. This case report addresses the specific knowledge gap regarding the potential for tirzepatide to trigger or exacerbate psoriasis flares in patients with a history of the condition.

Within 6 weeks of initiating tirzepatide treatment, the patient experienced a significant flare-up of his plaque psoriasis, characterized by the emergence of new, erythematous, scaly plaques. The Psoriasis Area and Severity Index (PASI) score, which was 0 at baseline, rapidly increased to 12, indicating moderate to severe disease activity. The new lesions affected approximately 15% of his body surface area, primarily on the trunk and extremities. The most critical finding was the rapid onset of a significant psoriasis flare, with a 12-point increase in PASI score from baseline, directly following tirzepatide initiation. Upon discontinuation of tirzepatide and commencement of topical corticosteroid therapy, the patient's psoriatic lesions showed marked improvement, with the PASI score returning to 2 within 8 weeks.