Cutaneous vasculitis induced by TNF inhibitors: a report of three cases.
We describe 3 rheumatoid arthritis (RA) patients with anti-tumor necrosis factor (TNF) therapy-induced cutaneous vasculitis. Two cases were induced by infliximab and the other, in whom cutaneous vasculitis was found early at the start of therapy, was induced by etanercept. Skin biopsy was obtained in 2 patients, with histology-proven leukocytoclastic vasculitis. One patient spontaneously improved after cessation of the TNF inhibitor. Two patients required oral corticosteroid, the efficacy of which was observed to be excellent and rapid.
Fujikawa
Keita
K
Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Kawakami
Atsushi
A
Hayashi
Tomayoshi
T
Iwamoto
Naoki
N
Kawashiri
Shin-ya
SY
Aramaki
Toshiyuki
T
Ichinose
Kunihiro
K
Tamai
Mami
M
Arima
Kazuhiko
K
Kamachi
Makoto
M
Yamasaki
Satoshi
S
Nakamura
Hideki
H
Ida
Hiroaki
H
Origuchi
Tomoki
T
Eguchi
Katsumi
K
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D000069285:Infliximab; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor; D012867:Skin / Q000187:drug effects / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept