title: Proactive infectious disease approach to dermatologic patients who are taking tumor necrosis factor-alfa antagonists: Part II. Screening for patients on tumor necrosis factor-alfa antagonists.
abstract: Tumor necrosis factor-alfa levels are linked to disease severity in patients with inflammatory conditions, such as psoriasis. Inhibitors of this cytokine are commonly used with significant success in the treatment of such inflammatory disorders. Their use, however, can be plagued by infectious complications. An awareness of potential infections associated with these therapies is critical in order to maximize preventive efforts both before and during therapy. This review provides a guide for dermatologists caring for patients in need of this type of biologic therapy to preemptively address the infectious risks. Part II of this continuing medical education article reviews recommended screening methods for patients undergoing evaluations for tumor necrosis factor inhibitor therapy for psoriasis or other dermatologic diseases, and discusses possible prophylactic strategies to use, including the appropriate use of immunizations.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Chirch
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Cataline
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Dieckhaus
authors.affiliation: Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: grant@uchc.edu.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Grant-Kels
mesh_terms: D001691:Biological Therapy / Q000009:adverse effects; D003141:Communicable Diseases / Q000175:diagnosis*; D018450:Disease Progression; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000188:drug therapy; D006660:Histoplasmosis / Q000139:chemically induced / Q000150:complications; D006801:Humans; D007114:Immunization; D016867:Immunocompromised Host; D008403:Mass Screening; D012871:Skin Diseases / Q000150:complications* / Q000188:drug therapy*; D014376:Tuberculosis / Q000139:chemically induced / Q000150:complications; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D014409:Tumor Necrosis Factor-alpha
keywords: biologic therapy; immunizations; opportunistic infection; psoriasis; tumor necrosis factor