Psoriasiform reactions to anti-tumor necrosis factor α therapy

Khang Nguyen, Ruth Ann Vleugels, Nicole F. Velez, Joseph F. Merola, Abrar A. Qureshi

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


OBJECTIVE: Given increasing concern about the adverse effects of anti-tumor necrosis factor α (anti-TNF-α) medications, we sought to characterize psoriasiform eruptions in patients on these medications. METHODS: In a retrospective review of patients at the Brigham and Women's Hospital combined dermatology-rheumatology clinic, we identified 13 patients (1 male and 12 female patients) who developed psoriasiform eruptions while on anti-TNF-α medications. RESULTS: Inciting medications were adalimumab, etanercept, and infliximab. Patients were on their inciting medication for a median time of 24 months and a mean time of 31.3 months before developing eruptions. Five of 7 patients experienced complete resolution of lesions with topical corticosteroids and discontinuation of anti-TNF-α medications with the remaining 2 patients having partial improvement. One of the other 6 patients experienced complete resolution with topical corticosteroid treatment only, with the remaining 5 patients experiencing partial improvement. After changing anti-TNF-α agents, 1 patient had partial improvement of psoriasiform lesions, and 7 patients had no improvement. CONCLUSIONS: All of the main anti-TNF-α medications currently used are capable of causing psoriasiform eruptions. Poor responders to topical agents, such as corticosteroids, may benefit from supplemental therapy aimed at the psoriasiform eruption or changing to a different class of immunomodulatory agents. Switching anti-TNF-α medications had a low likelihood of improving psoriasiform skin reactions, further suggesting that these eruptions are a drug class effect.

Original languageEnglish (US)
Pages (from-to)377-381
Number of pages5
JournalJournal of Clinical Rheumatology
Issue number7
StatePublished - Oct 1 2013


  • biological therapy
  • drug eruptions
  • infliximab
  • psoriasis
  • rheumatoid arthritis
  • tumor necrosis factor α

ASJC Scopus subject areas

  • Rheumatology


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