Summary

The treatment of psoriasis in patients with HIV infection represents a therapeutic challenge due to the potential impact on immune status and the risk of opportunistic infections.

We present the case of a 33-year-old male patient with chronic plaque psoriasis and well-controlled HIV infection under antiretroviral therapy, treated with tildrakizumab. At treatment initiation, the Psoriasis Area and Severity Index (PASI) score was 16 and the Dermatology Life Quality Index (DLQI) score was 14. Immunological parameters showed a CD4+ lymphocyte count of 512 cells/mm³ and an undetectable viral load.

After 3 months of treatment, the patient achieved a PASI 90 response, with significant clinical improvement and enhanced quality of life, without adverse reactions. Immunological status remained stable, with a CD4+ count of 528 cells/mm³ and persistently undetectable viral load. This case supports the efficacy and safety of IL-23 inhibitors in carefully monitored HIV-positive patients.