Infliximab-induced skin manifestations in patients with inflammatory bowel disease

Hellström, Alec Eligius; Färkkilä, Martti; Kolho, Kaija‐Leena

doi:10.3109/00365521.2015.1125524

Cited by 38 publications

(23 citation statements)

References 32 publications

(56 reference statements)

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“…Previous studies have reported the estimated incidence of paradoxical psoriasis in IBD patients receiving anti‐TNF agents . Although some single‐centre studies showed relatively high incidence rates up to 10%, the latest nationwide cohort study reported that 1.7% of IBD patients developed psoriasis during treatment with anti‐TNF agents .…”

Section: Discussionmentioning

confidence: 99%

Incidence of psoriasiform diseases secondary to tumour necrosis factor antagonists in patients with inflammatory bowel disease: a nationwide population‐based cohort study

Bae

Lee

et al. 2018

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 99%

Incidence of psoriasiform diseases secondary to tumour necrosis factor antagonists in patients with inflammatory bowel disease: a nationwide population‐based cohort study

Bae

Lee

et al. 2018

Aliment Pharmacol Ther

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“…However, recent results have associated these manifestations to IBD activity [51] and the use of TNF- α inhibitors [52], exemplified by hepatobiliary manifestations, in terms of frequency and severity [53–55]. At the same time, these IBD complications remain underdiagnosed [56].…”

Section: Discussionmentioning

confidence: 99%

Colonic and Hepatic Modulation by Lipoic Acid and/or N-Acetylcysteine Supplementation in Mild Ulcerative Colitis Induced by Dextran Sodium Sulfate in Rats

Moura

Andrade

Araújo³

et al. 2016

Oxidative Medicine and Cellular Longevity

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Lipoic acid (LA) and N-acetylcysteine (NAC) are antioxidant and anti-inflammatory agents that have not yet been tested on mild ulcerative colitis (UC). This study aims to evaluate the action of LA and/or NAC, on oxidative stress and inflammation markers in colonic and hepatic rat tissues with mild UC, induced by dextran sodium sulfate (DSS) (2% w/v). LA and/or NAC (100 mg·kg·day−1, each) were given, once a day, in the diet, in a pretreatment phase (7 days) and during UC induction (5 days). Colitis induction was confirmed by histological and biochemical analyses (high performance liquid chromatography, spectrophotometry, and Multiplex®). A redox imbalance occurred before an immunological disruption in the colon. NAC led to a decrease in hydrogen peroxide (H2O2), malondialdehyde (MDA) levels, and myeloperoxidase activity. In the liver, DSS did not cause damage but treatments with both antioxidants were potentially harmful, with LA increasing MDA and LA + NAC increasing H2O2, tumor necrosis factor alpha, interferon gamma, and transaminases. In summary, NAC exhibited the highest colonic antioxidant and anti-inflammatory activity, while LA + NAC caused hepatic damage.

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“…It is similarly worth noting that the use of anti-TNF-α bio-logics to treat IBD, especially CD, has probably increased the prevalence of noninfectious dermatoses in these patients. 177 Next to xerosis and atopic eczema exacerbations, psoriasis is the third most common skin manifestation provoked by the treatment with anti-TNF-α agents in these patients. 177 The vast majority of the cases (76%) developed psoriasis while on infliximab, and the rest (24%) after switching to adalimumab or certolizumab, indicating that this phenomenon is not drug specific, but rather a pharmacological group effect.…”

Section: Discussionmentioning

confidence: 99%

“… 177 Next to xerosis and atopic eczema exacerbations, psoriasis is the third most common skin manifestation provoked by the treatment with anti-TNF-α agents in these patients. 177 The vast majority of the cases (76%) developed psoriasis while on infliximab, and the rest (24%) after switching to adalimumab or certolizumab, indicating that this phenomenon is not drug specific, but rather a pharmacological group effect. 107 Cases of psoriasis induced by etanercept have been also reported.…”

Section: Discussionmentioning

confidence: 99%

Psoriasis and inflammatory bowel disease: links and risks

Vlachos¹,

Gaitanis²,

Κατσάνος

et al. 2016

PTT

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Psoriasis and the spectrum of inflammatory bowel diseases (IBD) are chronic, inflammatory, organotropic conditions. The epidemiologic coexistence of these diseases is corroborated by findings at the level of disease, biogeography, and intrafamilial and intrapatient coincidence. The identification of shared susceptibility loci and DNA polymorphisms has confirmed this correlation at a genetic level. The pathogenesis of both diseases implicates the innate and adaptive segments of the immune system. Increased permeability of the epidermal barrier in skin and intestine underlies the augmented interaction of allergens and pathogens with inflammatory receptors of immune cells. The immune response between psoriasis and IBD is similar and comprises phagocytic, dendritic, and natural killer cell, along with a milieu of cytokines and antimicrobial peptides that stimulate T-cells. The interplay between dendritic cells and Th17 cells appears to be the core dysregulated immune pathway in all these conditions. The distinct similarities in the pathogenesis are also reflected in the wide overlapping of their therapeutic approaches. Small-molecule pharmacologic immunomodulators have been applied, and more recently, biologic treatments that target proinflammatory interleukins have been introduced or are currently being evaluated. However, the fact that some treatments are quite selective for either skin or gut conditions also highlights their crucial pathophysiologic differences. In the present review, a comprehensive comparison of risk factors, pathogenesis links, and therapeutic strategies for psoriasis and IBD is presented. Specific emphasis is placed on the role of the immune cell species and inflammatory mediators participating in the pathogenesis of these diseases.

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Infliximab-induced skin manifestations in patients with inflammatory bowel disease

Abstract: Anti-TNF-α therapy is frequently associated with newly onset skin reactions, most commonly in patients with Crohn's disease. Non-infectious skin manifestations can be treated topically and do not require cessation of anti-TNF-α therapy.

Cited by 38 publications

References 32 publications

Incidence of psoriasiform diseases secondary to tumour necrosis factor antagonists in patients with inflammatory bowel disease: a nationwide population‐based cohort study

Incidence of psoriasiform diseases secondary to tumour necrosis factor antagonists in patients with inflammatory bowel disease: a nationwide population‐based cohort study

Colonic and Hepatic Modulation by Lipoic Acid and/or N-Acetylcysteine Supplementation in Mild Ulcerative Colitis Induced by Dextran Sodium Sulfate in Rats

Psoriasis and inflammatory bowel disease: links and risks

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