Leflunomide in dermatology

Boyd, Alan S.

doi:10.1016/j.jaad.2011.08.025

Cited by 23 publications

(19 citation statements)

References 61 publications

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“…Ayrıca güncel çalışmalarda alopesi areata patogenezinde sadece T hücrelerin rol oynamadığı, NK hücrelerin kıl folliküllerinde MHC klas I ve MICA ekspresyonunda artışla birlikte aktive oldukları ve düşük KIR (Killer cell Ig-like reseptör) ekspresyonu nedeniyle apoptotik yanıta yol açtıkları ifade edilmektedir 7 . Anti-TNF ajanlarla aynı molekül yapısına sahip olmamasına karşın leflunomid TNF-α'ya bağlı gen transkripsiyonunu bloke ederek parsiyel bir anti-TNF yanıtı oluşturmaktadır 3 . Leflunomide bağlı alopesi areata gelişiminde TNF-α'ya bağlı olmaksızın alternatif yoldan aktive olan sitokin ve kemokinlerin rol oynaması, oluşan parsiyel anti-TNF yanıtının ise sitokin regülasyonunu bozarak hastalığı tetiklemesi en olası mekanizma olarak karşımıza çıkmaktadır.…”

Section: Discussionunclassified

“…Leflunomidin terapötik dozlarda sadece lenfositler üzerinde etkisinin olabileceği düşünülmesine karşın, özellikle yükleme dozundan sonra gastrointestinal rahatsızlıklar başta olmak üzere bir çok yan etkiye neden olduğu saptanmıştır 2 . Leflunomide bağlı izlenen başlıca yan etkiler, hepatopati, hipertansiyon, kilo kaybı, pansitopeni ve periferik nöropatidir 3,4 . Bunların yanında leflunomide bağlı, geçici saç kaybı, ilaca bağlı subakut kutanöz lupus eritematozus, Sjögren sendromu, eritema multiforme, toksik epidermal nekroliz, mukokutanöz liken planus benzeri döküntü, likenoid ilaç erüpsiyonu, Reiter sendromu, lökositoklastik vaskülit, bacak ülserleri ve alopesi areata gibi dermatolojik yan etkilerin de izlendiği rapor edilmiştir 3 .…”

Section: Introductionunclassified

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A case of lenflunomide-induced alopecia areata

Açıkgöz¹,

Yeniay²,

Çalışkan³

et al. 2015

TURKDERM

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Leflunomide is an immunomodulatory drug widely used in the treatment of inflammatory arthritis, especially in rheumatoid arthritis and psoriatic arthritis. The common side effects of leflunomide are hepatopathy, hypertension, various gastrointestinal complaints and transient hair loss, which are all mild and reversible. Although leflunomide is associated with transient hair loss, only one case of leflunomide-induced alopecia areata has been reported previously. In this case report, we present a 38-year-old male patient who suffered from alopecia areata after leflunomide therapy. (Turkderm 2015; 49: 78-80)

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Section: Discussionunclassified

Section: Introductionunclassified

A case of lenflunomide-induced alopecia areata

Açıkgöz¹,

Yeniay²,

Çalışkan³

et al. 2015

TURKDERM

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“…Interestingly, hair thinning and decreased density have been repeatedly reported in clinical trials of teriflunomide in multiple sclerosis, affecting up to 13% of patients, but nail changes observed in our patient are characterized in contrast by plates’ thickening and closely mimic those usually observed in nail psoriasis. This probable side effect is surprising since the related molecule leflunomide, which is transformed after intake in active molecule teriflunomide, is also used in psoriatic arthritis treatment, a condition known for its link with nail psoriasis, and sometimes in skin psoriasis as well . This is perhaps another example of paradoxical psoriasiform reaction induced by a molecule otherwise efficiently used in psoriasis when it is employed in a nondermatological indication, by analogy with the currently well‐known and largely reported paradoxical reactions observed with anti‐TNF alpha agents when used in a similar setting .…”

mentioning

confidence: 86%

Teriflunomide‐induced psoriasiform changes of fingernails: a new example of paradoxical side effect?

Dereure

Camu

2017

Int J Dermatology

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“…While some patients noted improvement in symptoms, leflunomide can actually worsen SLE and should therefore be used with caution. It is thought that the suppression of tumor necrosis factor α associated with leflunomide may be the mechanism behind the reactivation of SLE [12] .…”

Section: New and Emerging Treatmentsmentioning

confidence: 99%

An update on the management of systemic lupus erythematosus

Sweet¹,

Mahdavian²,

Singh³

et al. 2013

J Hemat Malig

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Systemic lupus erythematosus (SLE) is an autoimmune disease that affecting at least 1.5 million Americans. The exact cause of SLE is unknown; however there are numerous factors that are thought to play a role in the development of SLE. While there are several medications available for the management of SLE, Belimumab is the first medication approved for SLE management in over 50 years. Researchers are investigating other medications that may provide some benefit in SLE management and improve patient outcomes. These emerging treatments explore other mechanisms for management and targeting symptoms. SLE has a higher mortality rate than other rheumatic diseases and new and continuous research is needed with the aim to decrease the number of deaths and improve patients' quality of life. Key wordsSLE, Autoimmune, Lupus, Pharmacotherapy, Interferon BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease that has the potential to affect every organ in the body; however the disease affects most commonly the skin, kidneys, brain, and joints. According to the Lupus Foundation of America, at least 1.5 million Americans have SLE, although the actual number may be higher; there have been no large-scale studies to solidify the exact number of individuals living with SLE in the U.S. Annually, there are more than 16,000 new cases of SLE reported across the country. Women of childbearing age are considered the population mostly affected by Lupus. Although people of all races and ethnic groups can develop lupus, African-American women are 2-3 times more likely to develop SLE than any other population. Over the years, the life expectancy of such patients has improved from an approximate 4-year survival rate of 50% in the 1950s to a 15 year survival rate of 80% today. The leading cause of death in patients with SLE is kidney failure; however other causes include infections, cerebrovascular disease, cardiovascular disease, and cancer [1] .The exact cause of SLE is not known, however environmental, genetic, and hormonal factors are all thought to possibly lead to the development and expression of SLE. Current data illustrates the risk for development of SLE in siblings of individuals with the disease is about 20 times higher than that of the general population. The rate of identical twins

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Leflunomide in dermatology

Cited by 23 publications

References 61 publications

A case of lenflunomide-induced alopecia areata

A case of lenflunomide-induced alopecia areata

Teriflunomide‐induced psoriasiform changes of fingernails: a new example of paradoxical side effect?

An update on the management of systemic lupus erythematosus

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