Ganesh Kumar

BRCA mutations are well established in breast and ovarian cancers and increasingly recognized in colorectal cancer (CRC), particularly BRCA1 . Dual BRCA1/2 pathogenic variants in CRC remain exceptionally rare. We report a case of early-onset CRC in a young male harboring pathogenic variants in BRCA1 , BRCA2 , and POLE , with no personal or familial cancer history. This mutational triad suggests convergence of homologous recombination deficiency and impaired DNA proofreading, resulting in a hypermutated phenotype. The case may represent a novel molecular CRC subtype and underscores the importance of broad-panel germline testing in young patients, with implications for poly (ADP‑ribose) polymerase and immune checkpoint inhibitor therapy.

Psoriasis is a chronic inflammatory disease characterized by scaly, erythematous plaques on any part of the body, especially the extensor surfaces. Secukinumab, an IL-17A inhibitor, is widely used clinically for conditions such as psoriasis and psoriatic arthritis with a good prognosis and minimum side-effect profile. Although rare, it can predispose to various significant infectious side effects, including bacterial and fungal infections, owing to its immunosuppressive and neutropenic effects. It has been associated with stable metabolic parameters, but some studies have reported metabolic disturbances with the IL-17A inhibitor therapy. We report a case of deranged liver studies along with fatty changes on ultrasound in a patient with psoriasis undergoing secukinumab therapy for 6 months, with significant improvement in skin and joint symptoms.