Autoimmune bullous skin diseases occurring under anti-tumor necrosis factor therapy: two case reports.

Abstract

BACKGROUND:

Anti-tumor necrosis factor (TNF) agents are increasingly being used for a rapidly expanding number of rheumatic and systemic diseases. As a result of this use, and of the longer follow-up periods of treatment, there are a growing number of reports of the development of autoimmune processes related to anti-TNF agents. The use of anti-TNF agents has been associated with more and more cases of autoimmune diseases, principally cutaneous vasculitis, lupus-like syndrome, systemic lupus erythematosus and interstitial lung disease.

OBSERVATIONS:

We report 2 cases of autoimmune bullous skin disease occurring in patients undergoing TNF-targeted therapy: a bullous pemphigoid and a pemphigus foliaceus. Both patients were treated by anti-TNF agents for rheumatoid arthritis and showed improvement following interruption of that treatment. Here, we discuss the relationship between anti-TNF therapy and the occurrence of autoimmune bullous disease.

CONCLUSION:

Anti-TNF agents should be considered as a potential cause of drug-induced autoimmune bullous skin disease.

• Authors: L Boussemart, S Jacobelli, F Batteux, C Goulvestre, P Grange, A Carlotti, J P Morini, I Gorin, J M Ziza, M F Avril, N Dupin
• Journal: Dermatology (Basel, Switzerland) (Dermatology) Vol. 221 Issue 3 Pg. 201-5 ( 2010) ISSN: 1421-9832 [Electronic] Switzerland
• PMID: 20720390 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• Autoantibodies
• Tumor Necrosis Factor Inhibitors
• Infliximab
• Adalimumab

Topics

• Adalimumab
• Aged
• Antibodies, Monoclonal (adverse effects, therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents (adverse effects, therapeutic use)
• Arthritis, Rheumatoid (drug therapy)
• Autoantibodies (blood)
• Drug Eruptions (etiology)
• Female
• Humans
• Infliximab
• Male
• Middle Aged
• Pemphigoid, Bullous (chemically induced, diagnosis)
• Pemphigus (chemically induced, diagnosis)
• Tumor Necrosis Factor Inhibitors