Dermatological Side Effects of Anti-tumor Necrosis Factor Alpha Therapy

Moon, Seong Hun; Ko, Joo Yeon

doi:10.4078/jrd.2014.21.1.9

Cited by 3 publications

(4 citation statements)

References 60 publications

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“…To our knowledge, this is the second case of TNF-α inhibitor induced PPD reported in literature with the previous being published in the Journal of Rheumatic Diseases (Korea) [10]. The causation mechanisms behind this phenomenon is unclear however reference can be sought from the paradoxical pro-inflammatory effects of TNF-α inhibitor in the treatment of inflammatory bowel disease, ankylosing spondylitis, and rheumatoid arthritis where skin eruptions have been reported as side effects [11].…”

Section: Discussionmentioning

confidence: 71%

TNF-α inhibitor induced pigmented purpuric dermatoses: a case report

Jhaveri

Zhao

2022

BMC Rheumatol

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Background We present a rare case of TNF-α inhibitor induced pigmented purpuric dermatoses (PPD) and explore its mechanisms and management. Case presentation A 44-year-old woman presented with non-pruritic non-tender petechial rash on bilateral lower limbs after being started on Adalimumab, with the rash progressing to worsen on Golimumab, both used for managing her seronegative peripheral arthritis. Laboratory panel revealed a negative vasculitis screen and skin biopsy confirmed the condition. After ceasing the TNF-α inhibitors and changing to Secukinumab, an Interleukin-17 inhibitor, the lesions stopped erupting and slowly resolved. Conclusion PPD is a benign skin condition and has been associated with various medications and exposure to chemicals in the literature. Different mechanisms have been proposed in the literature however its exact aetiology is unknown. To date, there is no standardized treatment however patients should be reassured that PPD is benign and will often regress by itself once the causative agent has been removed.

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Section: Discussionmentioning

confidence: 71%

TNF-α inhibitor induced pigmented purpuric dermatoses: a case report

Jhaveri

Zhao

2022

BMC Rheumatol

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“…It is perhaps therefore why vasculitis is often mentioned among the cutaneous side effects of TNFα inhibitors, whereas PPD has been reported in only a few case reports. [4][5][6][7] PPD must be differentiated from vasculitis for proper patient management. Histopathological examination has a great place in the differentiation of these 2 diseases.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are case reports of PPD induced by infliximab, adalimumab and golimumab and in our case, certolizumab pegol was the culprit (Table 1). [4][5][6][7] In the case of Wang et al, PPD developed in the 5th infusion (5 mg/kg: weeks 0, 9, 18, 26, 34) of infliximab and worsened with the 6th infusion. 4 Similarly, in the case of Jhaveri et al, PPD occurred 2 weeks after adalimumab administration, and the lesions increased after switching to golimumab 3 months later.…”

Section: Discussionmentioning

confidence: 99%

“…PPD cases may be misdiagnosed as vasculitis due to the similarity of their clinical presentations. It is perhaps therefore why vasculitis is often mentioned among the cutaneous side effects of TNFα inhibitors, whereas PPD has been reported in only a few case reports 4–7 . PPD must be differentiated from vasculitis for proper patient management.…”

Section: Discussionmentioning

confidence: 99%

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A case of certolizumab‐induced purpura annularis telangiectodes of Majocchi and literature review

Karstarlı Bakay,

Bakay

2023

Int J of Rheum Dis

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Tumor necrosis factor alpha (TNFα) inhibitors are now widely used to treat immune‐mediated inflammatory diseases. Although they have a good safety profile, they are also associated with adverse cutaneous events. Pigmented purpuric dermatoses (PPD) include a variety of skin diseases characterized by multiple petechial hemorrhages due to capillaritis. Five major clinical types of PPD have been described and purpura annularis telangiectodes of Majocchi (PATM) is a rare subtype of PPD. The cause of PPD is unknown, but drugs are implicated in a minority of cases. There are very few cases in the literature triggered by TNFα inhibitors. We present a case of PATM induced by certolizumab pegol and perform a review including 4 articles in the literature reporting 5 PPD cases induced by TNFα inhibitors. When purpuric eruptions develop in patients treated with TNFα inhibitors, PPD and vasculitis should be differentiated. Thus, patients are not exposed to unnecessary evaluations and treatments.

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The Effect of Orally Administered Herbal Medicines in Collagen, LPS, CFA Induced Rheumatoid Like Arthritis Animal Model: A Systematic Review of Animal Study Articles Published in Korea after 2008

Won¹,

Chaeheun²,

Song³

et al. 2017

J Korean Med Rehabil

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Objectives This study was designed to review animal studies about the efficacy of herbal medicine for Rheumatoid arthritis animal model which was published in Korea after 2008. We also systematically investigated the reporting quality of the animal studies. Methods We systematically searched original articles in 8 databases since 2008. And manual searching was conducted through 10 Korean medicine journals from 2008. Studies were included if they used animal experimental model(s) with orally administered herbal medicine. Data were extracted regarding animal model, rheumatoid arthritis indicator and detail of intervention. Reporting quality of each study was also assessed by the STARA and ARRIVE guidelines. Results Nine hundred two articles were screened. Finally, 35 articles were included. 35 studies all showed that the herbal medicine used in the studies has significant effect on alleviating the macroscopic indicators, hematological indicators, histological indicators, genetic indicators, osteological indicator of Rheumatoid Arthritis and others. Species of animals was reported in 100% while ventilation and noise were reported in 0% in STRASA guidelines. Ethical statement was reported in 42.9%, experimental animals and sample size were reported in 24%, 29% and there was no study reporting funding. Conclusions These results suggest that herbal medicine might be effective treatment for Rheumatoid Arthritis. It should be improved by clinical studies. And there is a need for studying about efficacy and safety of each specific herbal medicine. And we should improve the Reporting quality of the animal studies published in Korea.

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Dermatological Side Effects of Anti-tumor Necrosis Factor Alpha Therapy

Cited by 3 publications

References 60 publications

TNF-α inhibitor induced pigmented purpuric dermatoses: a case report

TNF-α inhibitor induced pigmented purpuric dermatoses: a case report

A case of certolizumab‐induced purpura annularis telangiectodes of Majocchi and literature review

The Effect of Orally Administered Herbal Medicines in Collagen, LPS, CFA Induced Rheumatoid Like Arthritis Animal Model: A Systematic Review of Animal Study Articles Published in Korea after 2008

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