title: Syringotropic hypersensitivity reaction associated with infliximab and leflunomide combination therapy in a child with psoriatic arthritis.
abstract: A 17-year-old boy with refractory psoriatic arthritis and alpha-1 antitrypsin deficiency who developed a syringotropic hypersensitivity reaction after 9 months of therapy with infliximab and leflunomide is described. Clinically, our patient showed a vasculitic-like skin rash involving both palms and soles, and histopathological examination revealed a syringotropic lymphocytic infiltrate directed toward the intra-epidermal portion of the eccrine ducts. These features have not been previously associated with infliximab or leflunomide therapy and represent a unique cutaneous hypersensitivity reaction that does not fit any known description of an immune-mediated hypersensitivity reaction.
authors.affiliation: Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital Ljubljana, Ljubljana, Slovenia.
authors.forename: Tina
authors.initials: T
authors.lastname: Vesel
authors.forename: Bostjan
authors.initials: B
authors.lastname: Luzar
authors.forename: Eduardo
authors.initials: E
authors.lastname: Calonje
authors.forename: Tadej
authors.initials: T
authors.lastname: Avcin
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000473:pathology; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000473:pathology; D004359:Drug Therapy, Combination; D006801:Humans; D000069285:Infliximab; D007555:Isoxazoles / Q000009:adverse effects*; D000077339:Leflunomide; D008297:Male
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D007555:Isoxazoles; D000069285:Infliximab; D000077339:Leflunomide