Use of Infliximab, an Anti-Tumor Necrosis Alpha Antibody, for Inflammatory Dermatoses

Drosou, Anna; Kirsner, Robert S.; Welsh, Esperanza; Sullivan, Thomas P.; Kerdel, Francisco A.

doi:10.1007/s10227-002-0134-1

Cited by 64 publications

(35 citation statements)

References 32 publications

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“…In a later step of the cascade, tumor necrosis factor α may also play a role in EF. Indeed, Drosou et al [39] used infliximab, a monoclonal antibody against tumor necrosis factor α, with encouraging effects.…”

Section: Discussionmentioning

confidence: 99%

“…In the meantime steroid therapy is indicated [13] to prevent symptoms such as joint contractures and carpal tunnel syndrome. Nonresponders and patients with contraindications for corticosteroids have been treated with different therapies which have all been reported to lead to improvement alone or in combination, such as antihistamines (hydroxyzine) [9], histamine 2 antagonists (cimetidine) [10, 16, 63], nonsteroidal antirheumatic drugs (ibuprofen) [10], hydroxychloroquine [11], extracorporeal or bath photochemotherapy [12, 13], cytostatics [4, 6, 64] and immunosuppressive agents [39, 65, 66]. Recently some in vitro data have suggested the use of α-interferon in EF, which could inhibit IL-5 production [17].…”

Section: Discussionmentioning

confidence: 99%

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Eosinophilic Fasciitis 30 Years after – What Do We Really Know?

Antic¹,

2006

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Background: Eosinophilic fasciitis (EF) is a rare fibrosing disorder associated with peripheral eosinophilia and scleroderma-like induration of the distal extremities which affects substantially quality of life. Although the disease has been described 30 years ago, the etiology and pathomechanisms are still obscure, and consensus for therapy is lacking. Numerous case reports of patients with EF exist but series are scarce. Patients and Methods: Eleven patients with EF from the Department of Dermatology, Kantonsspital Aarau, the University Hospital Basel and the Outpatient Clinic of Dermatology, Triemli Hospital Zurich, Switzerland, were retrospectively studied. Results: In 4 patients the initial diagnosis was not recognized by the referring nondermatologists. The median age was 55 years, excluding the youngest patient ever diagnosed with EF (age = 1 year). All patients showed an induration of the skin, which led to painful contractures in the joints in 3 cases. All but 2 patients demonstrated edema. A slight predominance of the upper extremities was observed. Sclerodactyly was noticed in 1 patient. Three patients reported an initial trauma at the affected site. Two patients were tested positive for borreliosis. One patient subsequently developed aplastic anemia and Hashimoto thyroiditis. Visceral or extracutaneous involvement was absent. Eight patients had a full or partial recovery under corticosteroids whereas in 2, improvement could be achieved only with cyclosporine, azathioprine or cyclophosphamide. Conclusions: The diagnosis of EF can be established by clinical, laboratory and histological findings. In general, corticosteroids are highly efficacious in EF and only a minority of patients need other immunosuppressive or cytostatic drugs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Eosinophilic Fasciitis 30 Years after – What Do We Really Know?

Antic¹,

2006

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“…Recently, 6 patients with recalcitrant PRP were treated successfully with infliximab, an anti-TNF-α monoclonal antibody. Drosou et al [18] reported on 3 patients with PRP who received 2 infliximab infusions at a dose of 5 mg/kg, resulting in a marked improvement of >75%. The treatment was well tolerated without any adverse events.…”

Section: Discussionmentioning

confidence: 99%

Exacerbation of Pityriasis Rubra Pilaris under Efalizumab Therapy

Klein

Szeimies²,

Landthaler³

et al. 2007

Dermatology

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A 60-year-old woman, diagnosed as having psoriasis vulgaris in 2004 and unresponsive to standard therapies, received weekly subcutaneous injections with efalizumab. Within 9 weeks of treatment a massive aggravation of skin lesions occurred with widespread orange-tinged erythroderma, islands of normal skin on the back and the inner side of the forearms and palmoplantar hyperkeratosis. A biopsy confirmed the clinical diagnosis of pityriasis rubra pilaris. After discontinuation of efalizumab and treatment with oral corticosteroids, acitretin (30 mg/day) and PUVA therapy, the skin lesions continuously improved. Efalizumab, a fully humanized monoclonal antibody against CD11a, inhibits various T cell processes important in the pathogenesis of psoriasis. Efalizumab has been approved for the treatment of moderate to severe psoriasis, but there are no reports in the literature on the use of efalizumab for pityriasis rubra pilaris.

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“…A PubMed search about the treatment of NL with biological agents returned 6 previously reported cases in the English-language literature [19,20,21,22,23,24]. Clinical characteristics are summarized in table 1.…”

Section: Discussionmentioning

confidence: 99%

“…Etanercept (a dimeric fusion protein) and infliximab (a humanized monoclonal antibody) both bind soluble and transmembrane-bound TNF-α and inhibit the TNF-α inflammatory cascade [15,16,17]. The reported response of NL to pentoxifylline [18], a partial TNF-α inhibitor, indicated a possible role of this cytokine in this disease and prompted some authors to initiate anti-TNF-α therapy in treatment-resistant NL [19]. …”

Section: Discussionmentioning

confidence: 99%

Necrobiosis Lipoidica Therapy with Biologicals: An Ulcerated Case Responding to Etanercept and a Review of the Literature

Suárez-Amor¹,

Pérez‐Bustillo²,

Ruíz‐González³

et al. 2010

Dermatology

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Necrobiosis lipoidica (NL) is an idiopathic chronic granulomatous skin condition. There is currently no standardized effective treatment of NL. Ulceration occurs in up to 35% of cases. Treatment of ulcerative lesions is challenging and often unsuccessful. On the basis of the implication of the tumor necrosis factor α (TNF-α) on the formation of granulomas, since 2003 anti-TNF-α agents have been employed in cases of NL refractory to other therapeutic agents. We report a 50-year-old white woman with treatment-resistant chronic ulcerative NL of both shins successfully treated with subcutaneous etanercept. A review of the published literature suggests that biological agents (etanercept and infliximab) should be considered as a therapeutic alternative mainly in ulcerative NL unresponsive to prior conventional regimens. The dose and duration of treatment with these agents is not defined, therefore it is required to report management of these patients in order to develop an optimal therapeutic strategy.

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Use of Infliximab, an Anti-Tumor Necrosis Alpha Antibody, for Inflammatory Dermatoses

Abstract: Infliximab was well tolerated in most patients and the majority benefited from the use of infliximab.

Cited by 64 publications

References 32 publications

Eosinophilic Fasciitis 30 Years after – What Do We Really Know?

Eosinophilic Fasciitis 30 Years after – What Do We Really Know?

Exacerbation of Pityriasis Rubra Pilaris under Efalizumab Therapy

Necrobiosis Lipoidica Therapy with Biologicals: An Ulcerated Case Responding to Etanercept and a Review of the Literature

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