Ann Dermatol.  2010 May;22(2):212-215. 10.5021/ad.2010.22.2.212.

A Case of Tumor Necrosis Factor-alpha Inhibitors-induced Pustular Psoriasis

• Park JJ
• Lee SC

• KMID: 2265398
• DOI: http://doi.org/10.5021/ad.2010.22.2.212

Abstract

Anti-tumor necrosis factor (TNF)-alpha agents promise better disease control for the treatment of ankylosing spondylitis resistant to classical disease-modifying treatments. Etanercept, a recombinant human TNF receptor fusion protein, is used to treat a variety of TNF-alpha-mediated diseases by inhibiting the biological activity of TNF-alpha. We experienced a case of pustular psoriasis in a 32-year-old man during anti-TNF-alpha therapy with etanercept. He had a history of ankylosing spondylitis for 2 years. Two years after treatment of etanercept, erythematous pustules developed on his palms and soles. He had no previous history of pustular psoriasis. The skin lesion improved as the etanercept therapy was stopped, but pustular skin eruption recurred as adalimumab, a different TNF-alpha inhibitor, was administered to manage his ankylosing spondylitis. Several TNF-alpha inhibitors have different molecular structures, but these inhibitors might have a similar potency to induce pustular psoriasis from this case.

Keyword

Adalimumab; Etanercept; Pustular psoriasis; TNF-alpha inhibitors

MeSH Terms

Adult
Antibodies, Monoclonal, Humanized
Humans
Immunoglobulin G
Molecular Structure
Necrosis
Psoriasis
Receptors, Tumor Necrosis Factor
Skin
Spondylitis, Ankylosing
Tumor Necrosis Factor-alpha
Adalimumab
Etanercept
Antibodies, Monoclonal, Humanized
Immunoglobulin G
Receptors, Tumor Necrosis Factor
Tumor Necrosis Factor-alpha