Infliximab
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First report of rosacea: case report A 61-year-old man developed severe rosacea during treatment with infliximab [Remicade] for ulcerative colitis. The man started treatment with infliximab 5 mg/kg at weeks 0, 2, 6 and every 8 weeks thereafter. He was also receiving azathioprine, mesalazine and prednisone. During his first infusion of infliximab, he experienced an acute antitumour necrosis factor (TNF)-α infusion reaction, which subsided with the use of antihistamines. He tolerated his second infliximab infusion well. However, on day 3 of his third infusion he reported persistent facial erythema with intermittent skin burning and stinging. These symptoms were aggravated by sunlight and heat. A clinical examination showed erythema, disseminated small papules and occasional pustules. Fields of telangiectasia on his face and neck were also evident, with the periocular skin largely spared. Findings of a skin biopsy were suggestive of rosacea. The man was treated with doxycycline and propranolol and his skin symptoms and lesions subsided. However, his rosacea recurred on the second day of his fourth infliximab dose. These symptoms lasted for 2 days and resolved without treatment modification. Rosacea did not recur during his subsequent infliximab infusions and his treatment for rosacea was discontinued 6 months after its initiation. At 15 months’ follow-up, his skin symptoms had not recurred. Kosmidou M, et al. Severe rosacea in a patient on infliximab for ulcerative colitis: pathophysiological considerations. Acta Dermato-Venereologica 89: 522-523, No. 801158109 5, 2009 - Greece
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of rosacea associated with infliximab. The WHO ADR database contained ten reports of rosacea (MedDRA) associated with infliximab.
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Reactions 9 Jan 2010 No. 1283
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