Infliximab
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Infliximab Psoriasis: 3 case reports Three patients developed psoriasis during treatment with infliximab for Crohn’s disease (CD). A 17-year-old girl had small and large bowel CD. She received IV infliximab 5 mg/kg on weeks 0, 2, 6 and every 8 weeks thereafter. After receiving her sixth dose of infliximab, she developed an erythematous papule and plaque eruption that affected her lower extremities and trunk. The eruption involved thick and adherent silver scales. She was diagnosed with psoriasis. She received an additional dose of infliximab, but her skin lesions did not improve. Infliximab was withdrawn, and she started receiving adalimumab. Her skin lesions resolved completely. A 14-year-old boy also had small and large bowel CD. He started receiving infliximab [dosage and route not stated]. After receiving his fourth dose of infliximab, he developed an eruption that was papulomacular and psoriasiform [duration of treatment to reaction onset not stated]. The eruption affected his hands, feet, trunk, groin and arms. His skin biopsy was described as psoriasiform epidermal hyperplasia with features that suggested psoriasis vulgaris. Infliximab was withdrawn, and he received prednisone. He started receiving adalimumab, and his skin lesions resolved. A 13-year-old boy had ileocecal and gastric CD. He received infliximab 5 mg/kg [route not stated] on weeks 0 and 2. Just before receiving his third dose at week 6, he developed erythematous plaques on his lower extremities with overlying scales. He was treated with a corticosteroid and phototherapy. Infliximab was withdrawn, and he received adalimumab. There was no change in his skin rash, so adalimumab was replaced by methotrexate. His skin rash resolved completely. Author comment: "[T]he timing of the development and resolution of dermatitis in our patients and the reports of psoriasis triggered by [tumour necrosis factor]-α inhibitors in adult immune-mediated conditions suggest a causal relationship with infliximab." Broge T, et al. Infliximab-associated psoriasis in children with crohn’s disease may require withdrawal of anti-tumor necrosis factor therapy. Inflammatory Bowel Diseases 19: E75-E77, No. 5, Apr 2013. Available from: URL: http:// 803087103 dx.doi.org/10.1097/MIB.0b013e3182802c93 - USA
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Reactions 18 May 2013 No. 1452
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