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Cutaneous side effects of anti-TNF agents: clinical and histological features, mechanisms and management |
Hépato-Gastro. Volume 19, Number 3, 164-9, Mars 2012, Mini-revue
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 Résumé
Texte intégral
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Author(s) : Soloniaina Hélio Razafimahefa, Brigitte Milpied-Homsi, Frank Zerbib |
Summary : The advent of anti-tumor necrosis factor (anti-TNF) biologic agents has revolutionized the management of chronic inflammatory diseases including inflammatory bowel diseases (IBD). As anti-TNF progressively being used in clinical practice, the mechanisms of action of anti-TNF are more elucidated. Beside their efficacy, anti-TNF biologic agents have been associated with a number of adverse events including cutaneous manifestations. Knowledge of these side effects helps practitioners to manage them. The most frequently encountered cutaneous side effects are: injection site reactions (ISR), infusion reactions (IR), cutaneous infections, psoriasiform eruptions. ISR result from delayed hypersensitivity mediated by T-lymphocytes. IR involves anaphylactoid reaction or hypersensitivity type III of Gell and Coombs reaction. Psoriasiform eruptions result from exacerbation of previous psoriasis, occurrence of psoriasis de novo or induction of psoriasiform lesions. Cutaneous reactions have various level of severity. However, discontinuation of anti-TNF therapy is usually not mandatory in case of cutaneous side effects. Symptomatic care is sufficient in most of cases to improve these cutaneous manifestations. |
Keywords : anti-TNF, cutaneous side effects, symptomatic care |
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