title: Autoimmune bullous skin diseases occurring under anti-tumor necrosis factor therapy: two case reports.
abstract: BACKGROUND
  Anti-tumor necrosis factor (TNF) agents are increasingly being used for a rapidly expanding number of rheumatic and systemic diseases. As a result of this use, and of the longer follow-up periods of treatment, there are a growing number of reports of the development of autoimmune processes related to anti-TNF agents. The use of anti-TNF agents has been associated with more and more cases of autoimmune diseases, principally cutaneous vasculitis, lupus-like syndrome, systemic lupus erythematosus and interstitial lung disease.
  
  
  METHODS
  We report 2 cases of autoimmune bullous skin disease occurring in patients undergoing TNF-targeted therapy: a bullous pemphigoid and a pemphigus foliaceus. Both patients were treated by anti-TNF agents for rheumatoid arthritis and showed improvement following interruption of that treatment. Here, we discuss the relationship between anti-TNF therapy and the occurrence of autoimmune bullous disease.
  
  
  CONCLUSIONS
  Anti-TNF agents should be considered as a potential cause of drug-induced autoimmune bullous skin disease.
authors: Department of Dermatology and Venereology, Hôpital Cochin, Paris, France.
authors: L
authors: L
authors: Boussemart
authors: S
authors: S
authors: Jacobelli
authors: F
authors: F
authors: Batteux
authors: C
authors: C
authors: Goulvestre
authors: P
authors: P
authors: Grange
authors: A
authors: A
authors: Carlotti
authors: J P
authors: JP
authors: Morini
authors: I
authors: I
authors: Gorin
authors: J M
authors: JM
authors: Ziza
authors: M F
authors: MF
authors: Avril
authors: N
authors: N
authors: Dupin
mesh_terms: D000068879:Adalimumab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001323:Autoantibodies / Q000097:blood; D003875:Drug Eruptions / Q000209:etiology; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000139:chemically induced* / Q000175:diagnosis; D010392:Pemphigus / Q000139:chemically induced* / Q000175:diagnosis; D000079424:Tumor Necrosis Factor Inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D001323:Autoantibodies; D000079424:Tumor Necrosis Factor Inhibitors; D000069285:Infliximab; D000068879:Adalimumab