title: A case of tumour necrosis factor-α inhibitor- and rituximab-induced plantar pustular psoriasis that completely resolved with tocilizumab.
abstract: Rituximab, a chimeric B-cell-depleting monoclonal antibody, is a well-established therapy for rheumatoid arthritis. It is emerging that classical psoriatic lesions and plantar pustular psoriasis (PPP) are cutaneous side-effects of this drug. Antitumour necrosis factor (anti-TNF) therapies have multiple documented side-effects including PPP and psoriasis. We report a patient who has rheumatoid arthritis, who failed on anti-TNF therapies and then was commenced on rituximab. Subsequently she developed localized PPP. Due to deterioration of her joint disease she was switched to the interleukin-6 blocker tocilizumab, and the PPP resolved.
authors.affiliation: Department of Dermatology, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, U.K.
authors.forename: P
authors.initials: P
authors.lastname: Jayasekera
authors.forename: R
authors.initials: R
authors.lastname: Parslew
authors.forename: A
authors.initials: A
authors.lastname: Al-Sharqi
mesh_terms: D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D011565:Psoriasis / Q000139:chemically induced* / Q000188:drug therapy; D000069283:Rituximab; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D003879:Dermatologic Agents; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; C502936:tocilizumab