title: Anti-TNFα antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease: an Irish Cohort Study.
abstract: OBJECTIVE
  To determine the prevalence of psoriasis in an IBD cohort with reference to clinical characteristics and anti-TNFα use.
  
  
  METHODS
  Patients with psoriasis and IBD were retrospectively identified from the IBD database at Tallaght Hospital from 2000 to 2015. Pertinent clinical data were obtained from patients notes including anti-TNFα exposure. Prevalence rates of genuine and reactive psoriasis were calculated and compared using Student's T -test. A P values of <0.05 was considered significant.
  
  
  RESULTS
  In total, 1384 IBD patients were identified. The overall prevalence rate of IBD and psoriasis was 2.4% ( n  = 33), with 1.8% ( n  = 25) in the Crohn's disease group and 0.6% ( n  = 8) in the ulcerative colitis group. Within the psoriasis group, 24% ( n  = 8 of 33) had reactive psoriasis. The prevalence rates of psoriasis in the non-biological and biological cohorts were similar 2.5% (25 of 981) and 2% (8 of 403), respectively. There was no significant association with reactive psoriasis and disease type. There was a trend towards higher rates of reactive psoriasis Adalimumab users, 3.6% (6 of 166) vs. 0.8% (2 of 237), OR = 4.283, P  = 0.077, 95% CI 0.854-21.483 in infliximab users. In addition, in our cohort, smoking was not associated with any form of psoriasis in IBD, OR = 1.377, 95% CI 0.061-3.087, P  = 0.437.
  
  
  CONCLUSIONS
  In our large study, the prevalence rate of reactive psoriasis was similar to the background rate of psoriasis in the overall IBD cohort (2.0 vs. 2.4%). A 2% prevalence rate represents a common adverse event that clinicians should be aware of.
authors.affiliation: From the Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin, Ireland.|Department of Gastrenterology, Tallaght Hospital, Dublin, Ireland.
authors.forename: S
authors.initials: S
authors.lastname: Kirthi Jeyarajah
authors.affiliation: From the Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin, Ireland.
authors.forename: A M
authors.initials: AM
authors.lastname: Tobin
authors.affiliation: From the Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin, Ireland.|Department of Gastrenterology, Tallaght Hospital, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Hussey
authors.affiliation: Centre for Research and Cure of Inflammatory Bowel Disease UOC, Institute of Medical Pathology Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Scaldaferri
authors.affiliation: From the Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin, Ireland.|Department of Gastrenterology, Tallaght Hospital, Dublin, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: McNamara
mesh_terms: D000068879:Adalimumab / Q000009:adverse effects / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D003875:Drug Eruptions / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000453:epidemiology; D000069285:Infliximab / Q000009:adverse effects / Q000627:therapeutic use; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011565:Psoriasis / Q000139:chemically induced* / Q000453:epidemiology; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab