Infliximab in recalcitrant severe atopic eczema associated with contact allergy.
Infliximab is an anti-tumour necrosis factor (TNF)-alpha chimeric monoclonal antibody which is effective in diseases associated with a T-helper (Th) 1 response, such as rheumatoid arthritis, Crohn's disease and psoriasis. There are sporadic case reports of atopic dermatitis (AD) induced or precipitated by anti-TNF-alpha therapy, which have been attributed to the switch towards Th2-mediated reactions. We report the case of a 30-year-old man with long-standing severe AD associated with contact allergy and poorly responding to conventional treatments. The use of infliximab resulted in a dramatic amelioration of AD lesions and pruritus, persisting at follow-up examinations over a 3-year period. Probably, the unexpected response to infliximab therapy in this case might be due to some peculiar features of AD in our patient (i.e. chronic-continuous course and concomitant contact allergy) which could have been responsible for a more preponderant recruitment of Th1 cells as compared to common forms of AD.
Department of Internal Medicine, Immunology and Infectious Diseases, II Unit of Dermatology, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
N
N
Cassano
F
F
Loconsole
C
C
Coviello
G A
GA
Vena
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D017449:Dermatitis, Allergic Contact / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D004351:Drug Resistance; D006801:Humans; D000069285:Infliximab; D008297:Male; D012867:Skin / Q000473:pathology
D000911:Antibodies, Monoclonal; D000069285:Infliximab