Abstract
Psoriasis is a chronic, immunologically mediated disease of multifactorial origin, with genes playing a key role and environmental factors, such as infections, often triggering its onset or exacerbation. While acute streptococcal infections are commonly linked to guttate psoriasis, viral and fungal infections have also been associated with psoriasis flares. We report a case of severe psoriasis exacerbation during viral parotitis caused by paramyxovirus in a 49-year-old male patient with a long-standing psoriasis diagnosis. Following successful treatment with secukinumab, the patient experienced a flare-up coinciding with symptoms of mumps infection. Serological tests confirmed the presence of mumps virus RNA. Secukinumab was discontinued, and treatment with risankizumab resulted in rapid remission of psoriasis. While paramyxovirus infections are not typically associated with psoriasis flares, emerging evidence suggests that dysregulated antiviral immune responses may induce IL-23 production, possibly contributing to inflammation in psoriasis. This case highlights the need for further research on the role of antiviral immune responses in psoriasis exacerbations and the potential therapeutic implications of targeting the IL-23 pathway.