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.
Cassano
N
N
Department of Internal Medicine, Immunology and Infectious Diseases, II Unit of Dermatology, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
Loconsole
F
F
Coviello
C
C
Vena
G A
GA
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