Discoid lupus erythematosus-like eruption induced by infliximab.
Lupus erythematosus-like syndromes have been reported as an adverse effect of anti-tumour necrosis factor-alpha therapy. We report the case of a patient with rheumatoid arthritis who developed a discoid lupus erythematosus-like eruption after treatment with infliximab. The rash consisted of diffuse scaly erythematous plaques on the face, trunk and extremities, and occurred in the context of elevated anti-nuclear and anti-double-stranded DNA antibody titres. Direct immunofluorescence of lesional skin showed linear deposition of IgG, IgM and C3. The lesions resolved completely after the discontinuation of infliximab and with the use of anti-malarial therapy. We discuss the clinical, histological and immunohistochemical features of this case and review the literature with respect to the incidence of lupus erythematosus-like syndromes in patients receiving tumour necrosis factor-alpha antagonists.
Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece. alstrat@hol.gr
A J
AJ
Stratigos
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C
Antoniou
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S
Stamathioudaki
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G
Avgerinou
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A
Tsega
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AD
Katsambas
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008179:Lupus Erythematosus, Discoid / Q000139:chemically induced*; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000150:complications
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab