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Adalimumab/etanercept/infliximab Psoriasiform eruptions: 13 case reports Twelve women and one man, aged 21–72 years, were identified in a retrospective review after they developed psoriasiform eruptions while receiving either adalimumab, etanercept or infliximab. Five patients were receiving adalimumab, five patients were receiving etanercept and three patients were receiving infliximab [dosages and routes not stated]. The patients were being treated with TNF-α inhibitor therapy for rheumatoid arthritis (10 patients), seronegative spondyloarthropathy (1 patient), Crohn’s disease (1 patient) and seronegative inflammatory arthritis (1 patient). The patients developed psoriasiform eruptions 2–120 months after initiation of TNF-α inhibitors. The morphology of the lesions included pustular, guttate and plaque varieties, with six patients displaying more than one type of morphology. Palmar or plantar eruptions occurred in six patients, with four patients developed palmoplantar pustulosis. All patients were treated with topical corticosteroids. TNF-α inhibitors were stopped for seven patients, after which there was complete resolution for five patients and partial improvement in two patients. Six patients continued TNF-α inhibitor therapy; only one of these patients had complete resolution of lesions, while five patients had partial improvement. Eight patients switched to another TNF-α inhibitor agent during therapy [specific drugs not stated]; none of these patients had complete resolution, and four patients later discontinued TNF-α inhibitor therapy completely. Author comment: "Our retrospective review of patients with psoriasiform eruptions following anti-TNF-α therapy revealed a number of psoriasiform morphologies developing on adalimumab, etanercept, and infliximab." Nguyen K, et al. Psoriasiform reactions to anti-tumor necrosis factor alpha therapy. JCR: Journal of Clinical Rheumatology 19: 377-381, No. 7, Oct 2013. Available 803095362 from: URL: http://dx.doi.org/10.1097/RHU.0b013e3182a702e8 - USA

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Reactions 9 Nov 2013 No. 1477