Infliximab-Associated Acneiform Eruption in a Patient With Inflammatory Bowel Disease

Khatana, Usman Feroze; Qamar, Ali; Ashfaq, Mohammad B

doi:10.7759/cureus.18213

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…In the present study, acne was associated with anti-TNF-α therapy and azathioprine use, but only anti-TNF-α was independently associated with this skin lesion. This association has also been found by others 11 . Curiously, this medication has beneficial results in acne manifestations from SAPHO syndrome 12 .…”

Section: Discussionsupporting

confidence: 89%

Prevalence of skin lesions in a sample of Brazilian patients with inflammatory bowel disease

Silveira,

Kroyzanovski,

Purim

et al. 2023

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: Inflammatory bowel diseases may have extra intestinal manifestations such as those affecting the skin. This study aimed to study skin manifestations in a cohort of Brazilian patients with inflammatory bowel diseases. METHODS: Epidemiological and clinical data were obtained through a cross-sectional study of 70 inflammatory bowel diseases patients and a control group comprising 50 healthy individuals. All patients were subjected to dermatological examination and photography of skin lesions. RESULTS: Out of the 70 inflammatory bowel diseases patients, 50 had ulcerative colitis and 20 had Crohn’s disease. Skin lesions occurred in 95.7% of the inflammatory bowel diseases patients and in 88% of individuals in the control group (p=0.001). Alopecia (p<0.0001), xerosis (p=0.03), striae (p=0.02), and acne (p=0.04) were more common in inflammatory bowel diseases patients than in the control group. Alopecia was more frequent in females (p=0.01) than in males. Two male patients, one with ulcerative colitis and the other with Crohn’s disease, had pyoderma gangrenosum. Erythema nodosum was not observed in both groups. CONCLUSION: There was a high prevalence of skin lesions in the Brazilian inflammatory bowel diseases patients. Additionally, alopecia, xerosis, striae, and acne were more common in patients with inflammatory bowel diseases than in those in the control group.

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Section: Discussionsupporting

confidence: 89%

Prevalence of skin lesions in a sample of Brazilian patients with inflammatory bowel disease

Silveira,

Kroyzanovski,

Purim

et al. 2023

Rev. Assoc. Med. Bras.

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“…For instance, we are aware that in asthma, IL-4 and IL-5 hold crucial roles, whereas in inflammatory bowel disease and rheumatoid arthritis, TNF-α levels are heightened as a result of chronic inflammation. Further, in chronic obstructive pulmonary disease, cigarette smoke promotes IL-8 production [45][46][47]. In the current COVID-19 pandemic, IL-6 and IL-8 are some of the relevant markers of the cytokine storm and may help in predicting the severity of inflammation [48].…”

Section: Practical Aspects and Unanswered Questionsmentioning

confidence: 99%

Function of Follicular Cytokines: Roles Played during Maturation, Development and Implantation of Embryo

et al. 2021

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A balance within the immune system is necessary for the proper development of ovarian follicles. Numerous cytokines were detected in follicular fluid, the role of which in reproductive physiology seems crucial. They influence the development and maturation of the follicle, ovulation, and corpus luteum formation, as well as embryo implantation and maintenance of pregnancy. The analysis of follicular fluid requires its collection by puncturing of the ovary, which is usually executed in connection with various gynaecological procedures. When interpreting such test results, clinical indications for a given procedure and the method of patient preparation should be taken into account. This review revealed the results of currently available studies on the concentration of pro-inflammatory cytokines in follicular fluid in various forms of infertility. Additionally, it presented cytokines, whose concentration has a significant impact on the size of ovarian follicles, their number, the effectiveness of in vitro fertilisation, development of the embryo, and chances of correct implantation. Despite the many recent publications, the knowledge of follicular fluid immunology in the context of reproductive pathology is superficial and further research is required to extensively understand the roles of individual cytokines in reproductive pathology. In the future, this knowledge may enable patients’ individual qualifications to individual methods of infertility treatment, as well as the possible adjustment of the treatment regimen to the patient’s immune profile.

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“…An additional 42 articles were excluded following full-text review, resulting in 57 articles (Figure). Of these, 53 articles reported individual clinical data from 64 patients. The remaining 4 articles only provided grouped data rather than individual patient data, so these studies were omitted when calculating the following summary statistics.…”

Section: Resultsmentioning

confidence: 99%

Role of Tumor Necrosis Factor–α Inhibitors in the Treatment and Occurrence of Acne

et al. 2023

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ImportanceTumor necrosis factor–α inhibitors (TNFis) approved to treat several inflammatory diseases are sometimes used off label to treat severe forms of acne that are refractory to conventional therapies. However, use of TNFis can also be followed by acne occurrence, suggesting an association between TNFis and acne. Most of the literature on the topic comprises case reports and series that have not been reviewed in a systematic manner.ObjectiveTo characterize the demographic characteristics, clinical presentations, treatments, and outcomes of patients receiving TNFis to treat acne and patients who develop acne following treatment of other conditions with TNFis.Evidence ReviewA systematic literature review was performed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. PubMed and Web of Science were searched from inception through October 17, 2022. Included studies reported on patients of any sex or age who received TNFis whose treatment was followed by resolution or occurrence of acne. Two independent reviewers screened studies based on predefined criteria and extracted data from each study, which were quantitatively combined.FindingsA total of 53 studies reporting on 64 patients who received TNFis for the treatment of acne (n = 47) or who experienced acne after treatment with TNFis for a different condition (n = 17) (mean age, 28.7 years; range, 12-64 years; 6 female individuals [8.8%]) were included. The TNFis used included adalimumab, infliximab, and etanercept. Among the 47 patients treated for acne with TNFis, most had previously received antibiotics (31 [66.0%]) or isotretinoin (32 [68.1%]). Most (44 [93.6%]) experienced partial improvement (25 [53.2%]) or clearance (19 [40.4%]) with very few adverse effects reported (3 [6.4%]). Acne manifested as part of an inflammatory syndrome for 30 patients (63.8%). Among the 17 patients treated TNFis for a different condition followed by the occurrence of acne, only 1 patient (5.9%) reported having a history of acne. Therapy with TNFis was either discontinued (8 [47.1%]) or altered (6 [35.3%]) in most patients due to acne occurrence, typically with improvement in symptoms.Conclusions and RelevanceThe results of this systematic review suggest that TNFis can be effective in treating refractory acne but can also be associated with the occurrence of acne in certain instances. Further studies elucidating the role that TNF plays in treating and inducing acne could yield insight into off-label TNFi use and acne pathogenesis, potentially guiding clinical care of patients with acne treated or induced by TNFis.

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Infliximab-Associated Acneiform Eruption in a Patient With Inflammatory Bowel Disease

Cited by 5 publications

References 5 publications

Prevalence of skin lesions in a sample of Brazilian patients with inflammatory bowel disease

Prevalence of skin lesions in a sample of Brazilian patients with inflammatory bowel disease

Function of Follicular Cytokines: Roles Played during Maturation, Development and Implantation of Embryo

Role of Tumor Necrosis Factor–α Inhibitors in the Treatment and Occurrence of Acne

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