Apremilast induced chronic diarrhea and malnutrition

Apremilast is used as a systemic therapy for the treatment of psoriasis and psoriatic arthritis. This drug is considered relatively safe with a very low incidence of serious side effects. Common side effects are diarrhea, nausea, headache, nasopharyngitis, upper respiratory tract infections which are mild to moderate in severity. Diarrhea tends to occur within 2 weeks of starting treatment and resolve spontaneously within 4 weeks without dose adjustment or discontinuation of therapy. Chronic diarrhea and malnutrition due to apremilast have not been reported yet. We report a case of apremilast induced chronic diarrhea leading to malnutrition, necessitating discontinuation of therapy.