Adverse Skin Reactions to Anti-TNF-Alpha Monoclonal Antibody Therapy

Abstract

Various adverse cutaneous reactions to anti-TNF-α monoclonal antibody have been reported. In clinical studies with infliximab (Remicade^®) adverse drug reactions were most frequently reported in the respiratory system and in the skin and appendages. We describe here 6 patients receiving anti- TNF-α therapy (infliximab) for Crohn’s disease or rheumatoid arthritis who consulted our out-patient department for adverse cutaneous reactions between November 1999 and February 2002. The following diagnoses were made: leukocytoclastic vasculitis, lichenoid drug reaction, perniosis-like eruption (2 patients), superficial granuloma annulare and acute folliculitis.

Identification of Novel Single Chain Fragment Variable Antibodies Against TNF-α Using Phage Display Technology

“…However, the side effects of these huge macromolecules and also their high production cost have restricted their application in patients stricken by inflammatory diseases. [17][18][19][20][21][22] In the current study, we aimed to identify antibodies against TNF-α, which are fully humanized and small enough with manageable physicochemical properties. 27 Tomlinson I&J libraries are non-immunized human phage libraries composed of scFv antibodies displaying phagemids that provide an enormous source of individual antibodies to be screened against any target of interest.…”

“…16 The application of these inhibitors is limited partially because of their low stability, high production cost, immunogenicity, and potential side effects. [17][18][19][20][21][22] Such complexities necessitate development of new TNF-α inhibitors which are smaller than the marketed medicines but still have appropriate affinity towards TNF-α. Therefore, the objective of the current study was to use phage display technology for the identification of anti-TNF-α scFv antibodies which are smaller in size while maintaining high blocking specificity.…”

Erythema dyschromicum perstans (ashy dermatosis) during the treatment with infliximab in a child with Crohn disease

“…There were also isolated cases of dermatitis herpetiformis, leukocytoclasis vasculitis and alopecia areata. Other reported skin abnormalities accompanying biological therapy include pustular lesions, non-specific vesicular skin eruptions and necrotizing fasciitis [14,15]. Moreover, biologic drugs have a relatively high potential for the induction of lupus erythematous [16].…”

Reactive Granulomatous Dermatitis during Anti-TNF Therapy: A Case Report and Review of the Literature

“…Drug induced skin lesions represent the most frequent side effect of anti-TNFα agents, presumably in susceptible individuals [3][4][5][6][7][8][9][10]. They include infusion/ injection site reactions, psoriasis and psoriasis-like lesions, lupus-like syndromes, vasculitis, cutaneous infections, eczematous reactions, lichenoid reactions, cutaneous lymphomas, skin cancers and granulomatous diseases [5][6][7][8][9][10].…”

“…They include infusion/ injection site reactions, psoriasis and psoriasis-like lesions, lupus-like syndromes, vasculitis, cutaneous infections, eczematous reactions, lichenoid reactions, cutaneous lymphomas, skin cancers and granulomatous diseases [5][6][7][8][9][10]. Many noninfectious cutaneous granulomatous reactions have been described in literature, such as granuloma annulare, cutaneous sarcoidosis and sarcoid-like granulomatosis [11,12].…”