Cutaneous side effects of anti-tumor necrosis factor biologic therapy: a clinical review.
BACKGROUND
Anti-tumor necrosis factor (anti-TNF) biologic agents have been associated with a number of adverse events.


OBJECTIVE
To review the cutaneous reactions that have been reported in patients receiving anti-TNF therapy.


METHODS
We performed a systematic MEDLINE search of relevant publications, including case reports and case series.


RESULTS
Reported cutaneous events included infusion and injection site reactions, psoriasiform eruptions, lupus-like disorders, vasculitis, granulomatous reactions, cutaneous infections, and cutaneous neoplasms. Infusion reactions and injection site reactions were definitely associated with anti-TNF administration, whereas all other events had a varying strength of association and severity, not necessarily requiring drug discontinuation.


CONCLUSIONS
Most information was derived from spontaneous case reports, where ascertainment biases and frequency of reporting may impair detection methodology and causal relationships.


CONCLUSIONS
As anti-TNF biologic agents are progressively being used in clinical practice, cutaneous adverse events will be encountered more frequently. Until more data are accumulated with respect to their pathogenesis and potential association with anti-TNF therapy, dermatologists should become more familiar with the clinical presentation and management of such events.
Moustou
Aikaterini-Evaggelia
AE
1st Department of Dermatology, Andreas Sygros Hospital, University of Athens Medical School, Athens, Greece.
Matekovits
Athina
A
Dessinioti
Clio
C
Antoniou
Christina
C
Sfikakis
Petros P
PP
Stratigos
Alexander J
AJ
D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001691:Biological Therapy / Q000009:adverse effects*; D003875:Drug Eruptions / Q000276:immunology / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007249:Inflammation / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha