REVIEW - The enigmatic development of psoriasis and psoriasiform lesions during anti-TNF therapy

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Semin Arthritis Rheum. 2008 Feb;37(4):251-5. Epub 2007 Jul 20.

The enigmatic development of psoriasis and psoriasiform lesions during

anti-TNF therapy: a review.

Grinblat B, Scheinberg M.

Physician, Hospital Israelita Albert Einstein, Sao o, Brazil.

OBJECTIVES: The paradoxical observation that antitumor necrosis factor

(anti-TNF) agents are capable of inducing psoriasis and psoriasiform

skin lesions while also being therapy for psoriasis gained substantial

support following the description of this condition by several

authors. Our aim was to review the literature of this subject.

METHODS: A retrospective review of the literature was performed using

the Medline database between 2005 and February 2007.

RESULTS: Since the first publication by our group in April 2005 to the

present, 50 cases of this type of dermatitis have been described. More

than half of the cases were associated with the use of infliximab.

Different presentations of psoriasis were reported, plaque form being

the most prevalent. A number of clinical and immunological

observations suggest a cytokine disequilibrium in patients receiving

chronic anti-TNF therapy leading to this condition. Treatment for the

skin disease includes changing the anti-TNF agent or discontinuing the

medication.

CONCLUSIONS: The appearance of psoriasis and psoriasiform lesions

during chronic anti-TNF therapy is dependent on the presence of known

and unknown interrelated factors. Enhanced clinician awareness of this

drug complication and further investigation of its mechanisms are

warranted.

PMID: 17640718

http://www.ncbi.nlm.nih.gov/pubmed/17640718

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