title: Infliximab-induced skin manifestations in patients with inflammatory bowel disease.
abstract: OBJECTIVE
  The use of infliximab in rheumatoid and inflammatory bowel diseases (IBD) has been associated with a variety of adverse skin reactions, including paradoxical psoriatic lesions. The prevalence and possible predictors for these lesions were under observation in our cross-sectional prospective study.
  
  
  METHODS
  Nurses screened the skin of 118 adult patients with IBD during infliximab infusions between 4 September 2013 and 30 September 2014 based on the structured questionnaire. Data on skin manifestations, concomitant medications, extraintestinal manifestations and inflammatory markers were collected for analysis.
  
  
  RESULTS
  Non-infectious skin manifestations were observed in 27 (22.9%) patients during the study period, of which eight (29.6%) were new-onset, eight (29.6%) were exacerbations of existing lesions and 11 (40.7%) were baseline lesions that did not worsen during the study. Scaling eczema was the most commonly described skin manifestation (n = 8; 29.6%), followed by exacerbated atopic eczema (n = 5; 18.5%) and plausible infliximab-induced psoriasiform lesions (n = 5; 18.5%). The strongest associating factor for skin manifestations was Crohn's disease, in nearly 80% of afflicted patients.
  
  
  CONCLUSIONS
  Anti-TNF-α therapy is frequently associated with newly onset skin reactions, most commonly in patients with Crohn's disease. Non-infectious skin manifestations can be treated topically and do not require cessation of anti-TNF-α therapy.
authors.affiliation: a Helsinki University Hospital, Clinic of Gastroenterology, University of Helsinki , Helsinki , Finland ;
authors.forename: Alec Eligius
authors.initials: AE
authors.lastname: Hellström
authors.affiliation: a Helsinki University Hospital, Clinic of Gastroenterology, University of Helsinki , Helsinki , Finland ;
authors.forename: Martti
authors.initials: M
authors.lastname: Färkkilä
authors.affiliation: b Helsinki University Hospital, Children's Hospital and Helsinki University , Helsinki , Finland.
authors.forename: Kaija-Leena
authors.initials: KL
authors.lastname: Kolho
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D003875:Drug Eruptions / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008297:Male; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D005765:Gastrointestinal Agents; D000069285:Infliximab
keywords: Crohn’s disease; drug eruption; psoriasis; tumour necrosis factor-alpha; ulcerative colitis