Two Cases of Cutaneous Adverse Effects Induced by Tumor Necrosis Factor-Alpha Inhibitors

• Main Authors: Ena Masukawa (Author), Yoshiaki Matsushima (Author), Koji Habe (Author), Keiichi Yamanaka (Author)
• Format: Book
• Published: Karger Publishers, 2021-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1662-6567; 10.1159/000511985
• Keywords: tumor necrosis factor-alpha inhibitor; biologics; adverse effect; alopecia areata; atopic dermatitis; urticaria; Dermatology; RL1-803
• Source: Case Reports in Dermatology, Vol 13, Iss 1, Pp 238-243 (2021)

Here, we report two cases of cutaneous adverse effects possibly induced by the use of tumor necrosis factor-alpha (TNF-α) inhibitors. The first case presented alopecia areata (AA) and atopic dermatitis (AD) that developed during the treatment of ulcerative colitis using infliximab; the other case presented urticaria and AD that developed during the treatment of rheumatoid arthritis using etanercept. AA, AD, and urticaria are relatively common skin diseases; however, they are not well known as adverse effects of TNF-α inhibitors. Although immunological studies were not performed, the clinical courses suggested that these skin disorders might have developed as a result of an immune four-way imbalance in T helper 1 (Th1), Th2, Th17, and regulatory T cells by the administration of TNF-α inhibitors.