No abstract

A case of necrotising fasciitis in a patient receiving infliximab, an antitumour necrosis factor alpha (TNF-α) agent for rheumatoid arthritis, is presented. A widespread confluent, erythematous, pustular skin rash was the presenting sign. There was no fever throughout this admission. β-Haemolytic group A streptococcus was isolated from blood cultures and skin swabs. The adductor muscles and fascia around the site of a previous hip arthroplasty were necrotic on exploration. The case highlights the risk of severe sepsis in patients on anti-TNF-α treatment.

No abstract

Swollen joint count 9.9 (6.8) 5.8 (7.5)* 2.3 (4.6)* PASI (psoriasis activity skin index) 12.1 (10.3) 1.7 (5.6)* 1.1 (2.7)* ESR (mm/1st h) 21.6 (15.5) 15.9 (9.4) 20.2 (20.4) CRP (mg/l) 0.9 (0.9) 0.7 (1.3) 0.2 (0.4)* *p<0.01 as compared with baseline (determined by t test for paired data).

No abstract