J Korean Rheum Assoc.  2010 Jun;17(2):200-204. 10.4078/jkra.2010.17.2.200.

Exacerbation of Psoriatic Skin Lesion followed by TNF-alpha Antagonist Treatment

• Oh JM
• Koh EM
• Kim H
• Lee J
• Ahn JK
• Cha HS
• Lee JH
• Jang KT

• KMID: 2201974
• DOI: http://doi.org/10.4078/jkra.2010.17.2.200

Abstract

TNF-alpha antagonists have been successfully utilized in the treatment of autoimmune diseases, including psoriasis and psoriatic arthritis. Paradoxically, new onset or exacerbation of psoriatic lesions during treatment with TNF-alpha antagonists have been reported. It has been postulated that TNF-alpha blockade may cause disruption in the balance between TNF-alpha and type 1 interferon (IFN)-alpha, which are the key players in the pathogenesis of psoriasis. We report a case of psoriasis exacerbation during TNF-alpha antagonist therapy in a 53-years-old man with ankylosing spondylitis. The patient has been treated with etanercept for 3 years and 7 months when he developed accelerated deterioration of psoriasis. His condition was previously under control solely by local treatment. Physical examination revealed vigorous desquamative lesions with silvery scale in both lower legs. Deterioration of psoriasis was attributed to etanercept therapy and was subsequently discontinued. Clinical improvement of psoriasis has been observed 2 months following cessation of etanercept.

Keyword

Psoriasis; TNF-alpha antagonists; Ankylosing spondylitis

MeSH Terms

Arthritis, Psoriatic
Autoimmune Diseases
Humans
Etanercept
Immunoglobulin G
Interferons
Leg
Physical Examination
Psoriasis
Receptors, Tumor Necrosis Factor
Skin
Spondylitis, Ankylosing
Tumor Necrosis Factor-alpha
Immunoglobulin G
Interferons
Receptors, Tumor Necrosis Factor
Tumor Necrosis Factor-alpha

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