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Psoriasis occurs in up to 8% of patients with Down syndrome and, although poorly characterized, appears to be correlated with immune imbalance in cells Th1 and biochemical changes of cyclic nucleotides. Case report: Female patient, 38 years old, with Down syndrome and psoriasis (initial PASI 30) since 18 years. Initially treated with cyclosporine and methotrexate and subsequently with etanercept, adalimumab and ustecinumab because of progressive loss of response (current PASI 10). Conclusion: We describe this case for the poor response to treatment including various biological agents. Potential poor adherence to therapy and immune dysfunction may limit the therapeutic options.

PSORÍASE EM PLACAS EM DOENTE COM SÍNDROME DE DOWN - POTENCIAL PATOFISIOLOGIA COMUM E DIFICULDADE DE TRATAMENTO