Exacerbation of psoriatic skin lesions in a patient with psoriatic arthritis receiving adalimumab

Borrás-Blasco, Joaquı́n; Gracia-Pérez, Antonio; Nuñez-Cornejo, C.; Rosique-Robles, J Dolores; Mateu-Puchades, Almudena; Casterá, M Dolores-Elvira; Rubio-Fabra, M

doi:10.1111/j.1365-2710.2008.00915.x

Cited by 18 publications

(15 citation statements)

References 11 publications

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“…Replication rates of chlamydia trachomatis, a common aetiological agent in ReA, are thought to be inversely proportional to TNF levels. Three patients taking TNF blockers who presented with pustolosis were found to be positive for chlamydia trachomatis DNA in the affected skin [90]. Further study is needed to clarify whether the psoriasiform lesions occurring in patients on anti-TNF therapy may rather represent Keratoderma blenorrhagicum.…”

Section: Safetymentioning

confidence: 95%

Treatment of ankylosing spondylitis and other spondyloarthritides

Braun

Baraliakos²

2009

Current Opinion in Rheumatology

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In this review, we especially cover not only the following themes of new clinical studies, efficacy regarding signs and symptoms, function and quality of life but also structural damage and the link between inflammation and new bone formation. The pharmacokinetics of infliximab including the formation of antibodies and the overall and long-term safety of anti-tumour necrosis factor agents is covered.

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Section: Safetymentioning

confidence: 95%

Treatment of ankylosing spondylitis and other spondyloarthritides

Braun

Baraliakos²

2009

Current Opinion in Rheumatology

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“…Exacerbation of psoriatic skin lesions in patients with psoriatic arthritis receiving treatment with adalimumab [9,10] and other anti-TNF agents [11] has been occasionally reported. The latency period (5 months) between the start of adalimumab and the development of paradoxical psoriasis in our patient is consistent with previous reports, but methotrexate withdrawal just prior to the start of the skin flare may have played a role.…”

Section: Discussionmentioning

confidence: 99%

Ustekinumab Treatment of TNF Antagonist-Induced Paradoxical Psoriasis Flare in a Patient with Psoriatic Arthritis: Case Report and Review

Puig¹,

Morales-Múnera²,

López‐Ferrer³

et al. 2012

Dermatology

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Background: Therapy with tumour necrosis factor α (TNF) inhibitors can be associated with paradoxical reactions, namely the de novo development or flaring of conditions that usually respond to these therapeutic agents, such as arthritis, inflammatory bowel disease, sarcoidosis or psoriasis. They are considered a class effect of these drugs, and their incidence ranges from 1 to 5%, with paradoxical psoriasis (psoriasis vulgaris, palmoplantar pustulosis, scalp psoriasis and their combinations) being most frequently reported. Treatment of paradoxical psoriasis often requires withdrawal of the inducing drug and switching to another anti-TNF agent, but often this cannot avoid recurrence or persistence of the rash and/or loss of the therapeutic effect on the underlying condition. Case Report: We report on a 47-year-old woman who developed incapacitating palmoplantar pustulosis and psoriasis vulgaris flare with severe scalp and nail involvement after 5 months of treatment with adalimumab for psoriatic arthritis. Several treatments, including topical corticosteroids, photochemotherapy, ciclosporin, acitretin and etanercept 50 mg twice a day for 1 month, were ineffective or not tolerated. Treatment with ustekinumab 45 mg provided complete resolution of skin lesions with acceptable therapeutic control of the arthritis, with a follow-up duration of 16 months. Conclusion: A review of the reported cases suggests that this may be a therapeutic option in patients who develop paradoxical psoriasis while under treatment for arthritis or Crohn’s disease.

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“…Therefore, taking a careful medical history, superintend redundant medicine consumption and drug interaction are a critical step for prevention. There are many reports in the literature regarding the initiating, triggering and aggravated roles of drugs in psoriasis etiopathogenesis [1–8]. However, it is difficult to prove in an antidepressant receiving patient whether the stress or drug is a triggering factor.…”

Section: Introductionmentioning

confidence: 99%

“…Even biological agents, which have been reported as successful in psoriasis treatment in recent years, have also been reported that they may cause exacerbations of psoriasis lesions [8–11]. …”

Section: Introductionmentioning

confidence: 99%

Triggering drug use in patients with psoriasis: an investigative report from Turkey

Öğretmen

Aşkin

Hız

et al. 2014

pdia

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IntroductionThe patients clinically diagnosed with psoriasis were investigated for drug use that may trigger psoriasis.AimTo minimize the triggering drug use and help the medical treatment of psoriasis patients.Material and methodsThe study involved 289 psoriatic patients who attended our clinic in 2010–2012 and were asked to bring their drug lists of the last year, which they obtained from the pharmacy's record system. They were advised not to use the drugs that may trigger psoriasis. Data analyses were performed using SPSS program version 19.0.ResultsA total of 289 patients were included in the study. Two hundred and twenty-one patients were using non-steroidal anti-inflammatory drugs; 133 patients were using anti-reflux drugs; 35 patients were using antidiabetic drugs; 31 patients were using calcium-channel blockers and 24 patients were using β-blockers. In our study group, there was no significantly difference between median PASI scores of the patients using a triggering drug and those of who are not using a triggering drug. However, there was a positive low correlation between PASI rates and numbers of drugs used (r = 0.180, p = 0.013).ConclusionsMany other factors may trigger psoriasis, therefore the effect of stopping or minimizing the drug use on disease remission is not known. Because of the high triggering drug use rate, it is important to enlighten psoriasis patients about triggering drugs.

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Exacerbation of psoriatic skin lesions in a patient with psoriatic arthritis receiving adalimumab

Abstract: Patients initiated on adalimumab therapy should be closely monitored for the development of exacerbation of psoriasis. Clinicians should be aware of this rare adverse effect of this anti-TNF drug.

Cited by 18 publications

References 11 publications

Treatment of ankylosing spondylitis and other spondyloarthritides

Treatment of ankylosing spondylitis and other spondyloarthritides

Ustekinumab Treatment of TNF Antagonist-Induced Paradoxical Psoriasis Flare in a Patient with Psoriatic Arthritis: Case Report and Review

Triggering drug use in patients with psoriasis: an investigative report from Turkey

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