Abstract | BACKGROUND: Although the development of therapy-related skin reactions is common along with an increase in the number of adult patients receiving anti-TNFα, there are few studies on pediatric inflammatory bowel disease; hence, this prospective study focuses on skin reactions related to infliximab therapy. METHODS: RESULTS: During the study period, 84 children with inflammatory bowel disease (Crohn's n = 64) received infliximab infusions (the median duration of therapy 12.2 mo). Almost every other patient (n = 40; 47.6%) presented chronic skin reactions, 23% with lesions considered severe. Most commonly, the patient's ear lobes and scalp were affected with psoriasis-like manifestations, followed by their eyelids, perioral and pubic area, trunk, and the extremities. However, an HLA-Cw*0602 genotype associating with psoriasis was rare. Interestingly, most patients with skin reactions had a low degree of intestinal inflammation based on their fecal calprotectin levels (median level, 133 μg/g versus 589 in unaffected patients; P < 0.016). Seven patients (8.3% of all patients but 17% of those with skin lesions) discontinued the given therapy due to a skin reaction. CONCLUSIONS: Skin reactions are common during maintenance therapy with infliximab in pediatric patients. For most patients, skin reactions seem to correlate with a low level of intestinal inflammation. Although potentially harsh, skin lesions mostly allow continuation of infliximab.
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Authors | Tarja Mälkönen, Anne Wikström, Kaarina Heiskanen, Laura Merras-Salmio, Harri Mustonen, Taina Sipponen, Kaija-Leena Kolho |
Journal | Inflammatory bowel diseases
(Inflamm Bowel Dis)
Vol. 20
Issue 8
Pg. 1309-15
(Aug 2014)
ISSN: 1536-4844 [Electronic] England |
PMID | 24918318
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Monoclonal
- Gastrointestinal Agents
- Tumor Necrosis Factor-alpha
- Infliximab
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Topics |
- Adolescent
- Adult
- Antibodies, Monoclonal
(administration & dosage, adverse effects)
- Child
- Female
- Finland
- Follow-Up Studies
- Gastrointestinal Agents
(administration & dosage, adverse effects)
- Humans
- Inflammatory Bowel Diseases
(drug therapy)
- Infliximab
- Infusions, Intravenous
- Male
- Prognosis
- Prospective Studies
- Psoriasis
(chemically induced)
- Time Factors
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
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