A case report and literature review published in Frontiers concludes that guselkumab, the interleukin-23 inhibitor, is effective in the treatment of inverse psoriasis — a disease variant for which controlled trial data remain scarce.

Inverse psoriasis affects intertriginous sites such as the axillae, inguinal folds and inframammary skin. The authors of the Frontiers paper present a single-patient case supported by a review of the published literature on guselkumab in this indication.

What does the report add?

Guselkumab targets the p19 subunit of IL-23 and carries established regulatory approvals in plaque psoriasis and psoriatic arthritis. The new report extends the clinical narrative to intertriginous disease, where thin skin, friction and maceration complicate both topical and systemic management.

The authors pair their patient case with a structured literature review, pooling published experience to assess how the monoclonal antibody performs in this hard-to-treat phenotype.

Why inverse psoriasis resists standard care

Intertriginous lesions respond poorly to many conventional approaches. Corticosteroid use in body folds carries atrophy risk, and irritation limits tolerability of several topical agents. Systemic options validated in plaque psoriasis lack dedicated trial datasets for the inverse variant.

That evidence gap explains the value of case reports and literature syntheses: they build the observational foundation that randomized trials have not yet supplied for this population.

What comes next

The Frontiers publication adds a documented patient outcome and a consolidated literature view to the case for IL-23 blockade in inverse psoriasis. Larger controlled studies will be needed to confirm these findings and to define the place of guselkumab relative to other biologics in intertriginous disease.