Abstract | BACKGROUND: Anti- TNFalpha drugs are used in certain rheumatologic and gastrointestinal inflammatory diseases and are also effective in cutaneous psoriasis. Several case reports have recently been published concerning induction of paradoxical psoriasis during the course of anti-TNF therapy. We report a new case involving infliximab used to treat Shulman fasciitis. CASE REPORT: DISCUSSION:
TNFalpha plays an important role in the physiopathology of psoriasis through its action on inflammatory infiltrate, angiogenesis and keratinocyte proliferation. Several studies have reported the efficiency of TNFalpha inhibitors in moderate to severe cutaneous psoriasis. However, fourteen cases of induction or worsening of psoriasis have been reported with these drugs, suggesting a class effect. We report a new case of cutaneous psoriasis induced by infliximab in a patient presenting corticoid-dependent Shulman fasciitis, and we discuss the possible immunological mechanisms responsible for this paradoxical side effect. Other cutaneous lesions have been reported during treatment with TNFalpha inhibitors. The benefits of this treatment on the underlying inflammatory disease must be balanced against the potential cutaneous side effects when deciding whether to continue with anti- TNFalpha treatment.
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Authors | A Cavailhes, S Ingen-Housz-Oro, S Djennane, M Rafaa, F Fiszenson-Albala, N Weber, M Sigal-Grinberg |
Journal | Annales de dermatologie et de venereologie
(Ann Dermatol Venereol)
Vol. 134
Issue 4 Pt 1
Pg. 363-7
(Apr 2007)
ISSN: 0151-9638 [Print] France |
Vernacular Title | Survenue d'un psoriasis au cours d'un traitement par infliximab pour fasciite de Shulman. |
PMID | 17483757
(Publication Type: Case Reports, English Abstract, Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Dermatologic Agents
- Infliximab
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Topics |
- Adult
- Antibodies, Monoclonal
(adverse effects)
- Dermatologic Agents
(adverse effects)
- Edema
(chemically induced)
- Fasciitis
(drug therapy)
- Female
- Humans
- Inflammation
(chemically induced)
- Infliximab
- Psoriasis
(chemically induced)
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