Lichen planus–like eruptions: An emerging side effect of tumor necrosis factor-⍺ antagonists - 07/08/11
Reprint requests: Michelle L. Bush, MD, Department of Dermatology, Tufts Medical Center, 800 Washington St, 114, Boston, MA 02111.Abstract |
As tumor necrosis factor (TNF)-⍺ inhibitors gain wider use in clinical practice, it is becoming increasingly evident that these potent immunosuppressants can also induce inflammatory reactions. We present two cases of lichen planus–like eruptions after infliximab and adalimumab therapy for psoriasis, and review the literature on this phenomenon. Eleven cases of lichen planus or lichenoid drug eruptions have been previously reported in patients taking TNF-⍺ inhibitors, in addition to several cases of psoriasiform eruptions with a lichenoid histology. Because TNF-⍺ has been implicated in the pathogenesis of lichen planus, induction of lichenoid reactions by TNF-⍺ inhibition is somewhat unexpected. We consider potential immunologic mechanisms, and suggest that TNF-⍺ inhibition may precipitate lichenoid reactions through disruption of a delicate balance between TNF-⍺ and interferon-⍺ in susceptible patients.
Le texte complet de cet article est disponible en PDF.Abbreviations used : IFN, LP, NACDG, TNF
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| Supported by a generous grant from Ms Joan Fabry. Tufts Medical Center has received educational/research grants from Centocor, Amgen, Wyeth, Immune Control, Celgene, Incyte, and Abbott. |
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| Disclosure: Almost all of Dr Gottlieb’s income is paid to her employer. Dr Gottlieb has speakers’ bureau memberships with Amgen Inc and Wyeth Pharmaceuticals. Dr Gottlieb has current consulting/advisory board agreements with Amgen Inc, Centocor Inc, Wyeth Pharmaceuticals, Celgene Corp, Bristol Myers Squibb Co, Beiersdorf Inc, Warner Chilcott, Abbott Laboratories, Roche, Sankyo, Medarex, Kemia, Celera, TEVA, Actelion, UCB, Novo Nordisk, Almirall, Immune Control, RxClinical, Dermipsor Ltd, Medacorp, DermiPsor, Can-Fite, Incyte, and Corgentech. Ms Fabry is a patient of Dr Gottlieb’s and gave an unrestricted grant to support psoriasis research. Dr Massarotti receives consulting/honoraria from Bristol Myers Squibb, UCB, Genentech, Abbott, and PAI. Dr Bush has received research funding from Centocor. Mr Asarch, and Drs Lee, Masterpol, Scheinman, and Stadecker have no conflicts of interest to declare. |
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| Case 1 was presented at a meeting of the New England Dermatological Society at Tufts Medical Center, Boston, MA, on December 1, 2007. |
Vol 61 - N° 1
P. 104-111 - juillet 2009 Retour au numéro
Article précédent
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