Psoriasis and psoriatic arthritis induced in a patient treated with infliximab for Crohn’s disease

Abstract

The induction of psoriasis as a side effect of treatment with TNF-alpha inhibitors is one of a few rare complications of treatment, the pathogenic mechanism of which has not yet been completely clarified. The clinical presentation of these reactions may show the typical characteristics of psoriasis, palmoplantar pustulosis and psoriasiform exanthema; the individual variations of which may combine to give different presentations in individual patients. We present the case of a patient who, after administration of infliximab indicated for Crohn's disease, developed not only skin manifestations but also those of psoriatic arthritis.

The onset of psoriasis during the treatment of inflammatory bowel diseases with infliximab: should biological therapy be suspended?

“…However, these data must be cautiously interpreted because anti-TNF-α withdrawal can determine the aggravation of intestinal manifestations (3,8,17,31,38,40) . Based on the present review (1,-3, 5, 7-9, 11, 12, 15-18, 21-23, 25-31, 33-36, 38-44) , the IBD patients developing psoriasis during infliximab therapy must be treated by the conventional psoriasis approach (topical corticosteroids, phototherapy, vitamin-D analogs, methotrexate and/or cyclosporine) without the need to suspend infliximab.…”

Possible paradoxical occurrence of inflammatory arthritis in patients with psoriasis treated with biologics: findings in the Biobadaderm cohort

“…Exacerbation of rheumatoid arthritis and PsA has also been described during anti‐TNF treatment . Cases of PsA arising de novo during treatment with anti‐TNF drugs or ustekinumab are exceptionally rare …”

Psoriasis associated with anti‐tumour necrosis factor therapy in inflammatory bowel disease: a new series and a review of 120 cases from the literature

“…13 There have been 23 cases reported in 12 publications that were not included in either of the above reviews. [16][17][18][19][20][21][22][23][24][25][26] Details on individual cases were not available for six patients in one series and were excluded from this analysis leaving a total of 58 cases. 27 The GETAID group described 62 cases, 48 of which occurred in patients with no prior history of psoriasis.…”