Cutaneous side-effects in patients with rheumatic diseases during application of tumour necrosis factor-α antagonists
Cutaneous side-effects in patients with rheumatic diseases during application of tumour necrosis factor-α antagonists
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DOI：
10.1111/j.1365-2133.2007.07682.x
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发表时间：
2007-03-01
影响因子：
10.3
通讯作者：
Worm, M.
中科院分区：
文献类型：
--
作者：
Lee, H-H.;Song, I-H.;Worm, M.
背景风湿性疾病患者接受抗肿瘤坏死因子（TNF）-α为基础的治疗可能发展皮肤reactions.Objectives分析新的发病或恶化的皮肤病变的风湿性疾病患者在治疗过程中与TNF-α antagonists.Methods我们进行了前瞻性分析的35 150例风湿性疾病的长期病史，包括类风湿性关节炎，强直性脊柱炎（Bechterew氏病）和银屑病关节炎，以测试抗TNF-α（英夫利昔单抗，阿达木单抗或依那西普）treatment.Results慢性炎症性皮肤病，如银屑病和湿疹样表现的发展代表了大多数情况下（16 35）。在许多患者中还观察到病毒、细菌和真菌引起的皮肤感染（13/35）。皮肤病，如疱疹样皮炎，白细胞破碎性血管炎和脱发发生在单一casesonlines.Conclusions，我们观察到一个广泛的，多样化的临床谱与大多数慢性炎症和感染性皮肤病。然而，我们没有确定个体风险因素，如果进行了充分的皮肤病治疗，则不需要停止抗TNF-α治疗。基于抗TNF-α的治疗中皮肤副作用的发生应通过全国注册来确定。
Background Patients with rheumatic diseases receiving antitumour necrosis factor (TNF)-alpha-based treatment may develop cutaneous reactions.Objectives To analyse the new onset or aggravation of skin lesions in patients with a rheumatic disease during treatment with TNF-alpha antagonists.Methods We conducted a prospective analysis of 35 of 150 patients with a long history of rheumatic disease, including rheumatoid arthritis, ankylosing spondylitis (Bechterew's disease) and psoriatic arthritis, to test for the development of cutaneous manifestations during anti-TNF-alpha (infliximab, adalimumab or etanercept) treatment.Results Chronic inflammatory skin diseases such as psoriasis and eczema-like manifestations represented the majority of cases (16 of 35). Cutaneous infections caused by viral, bacterial and fungal agents were also observed in many patients (13 of 35). Skin diseases such as dermatitis herpetiformis, leucocytoclastic vasculitis and alopecia occurred in single cases only.Conclusions We observed a broad, diverse clinical spectrum with a majority of chronic inflammatory and infectious skin diseases. However, we did not identify individual risk factors and a discontinuation of the anti-TNF-alpha treatment was not necessary if adequate dermatological treatment was performed. The onset of cutaneous side-effects in anti-TNF-alpha-based treatments should be determined by nationwide registries.