title: Eczema as an adverse effect of anti-TNFα therapy in psoriasis and other Th1-mediated diseases: a review.
abstract: BACKGROUND
  There have been rare reports of eczema occurring as an adverse effect of anti-tumor necrosis factor-alpha (TNFα) therapy.
  
  
  METHODS
  A literature search was conducted on PubMed for articles describing new onset or worsening of preexisting eczema during anti-TNFα therapy for the treatment of various inflammatory diseases.
  
  
  RESULTS
  Eczema as an adverse effect of anti-TNFα therapy may occur in approximately 5-20% of patients with various Th1-mediated inflammatory diseases such as psoriasis, inflammatory arthritis and inflammatory bowel disease. Personal history of atopy appears to increase this risk. Out of the anti-TNFα agents indicated for the treatment of moderate-to-severe psoriasis, infliximab may be more strongly associated with development or exacerbation of preexisting eczema.
  
  
  CONCLUSIONS
  Inhibitors of key mediators in the Th1 pathway such as TNFα are successful therapeutic targets for the treatment of various inflammatory conditions such as psoriasis, psoriatic arthritis, rheumatoid arthritis and inflammatory bowel disease. Blocking the Th1 pathway may create an imbalance favoring increased activity of the opposing Th2 pathway implicated in inflammatory conditions such as eczema. Further research is needed to better understand the role of the Th1/Th2 balance in various inflammatory diseases and how the immunologic environment is affected by immunotherapies.
authors: a Department of Dermatology , University of California San Francisco , San Francisco , CA , USA.
authors: Mio
authors: M
authors: Nakamura
authors: a Department of Dermatology , University of California San Francisco , San Francisco , CA , USA.
authors: Kristina
authors: K
authors: Lee
authors: b University of California Los Angeles, David Geffen School of Medicine at UCLA , Los Angeles , CA , USA.
authors: Rasnik
authors: R
authors: Singh
authors: c University of Southern California Keck School of Medicine , Los Angeles , CA , USA.
authors: Tian Hao
authors: TH
authors: Zhu
authors: d University of Vermont College of Medicine , Burlington , VT , USA.
authors: Benjamin
authors: B
authors: Farahnik
authors: e University of California - Irvine, School of Medicine , Irvine , CA , USA.
authors: Michael
authors: M
authors: Abrouk
authors: a Department of Dermatology , University of California San Francisco , San Francisco , CA , USA.
authors: John
authors: J
authors: Koo
authors: a Department of Dermatology , University of California San Francisco , San Francisco , CA , USA.
authors: Tina
authors: T
authors: Bhutani
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D004485:Eczema / Q000209:etiology*; D006801:Humans; D000069285:Infliximab / Q000009:adverse effects / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy / Q000473:pathology; D018417:Th1 Cells / Q000276:immunology* / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology* / Q000378:metabolism
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab
keywords: Atopic dermatitis; TNF-alpha inhibitor; biologic