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oai:recercat.cat:11351/110152025-10-24T11:00:14Zcom_2072_451665com_2072_378040col_2072_451666

2025-10-24T11:00:14Z urn:hdl:11351/11015 Efectos adversos cutáneos inmunomediados por los anti-TNF: revisión de 30 casos Immune-Mediated Skin Reactions to Tumor Necrosis α Inhibitors: A Review of 30 Cases Sin-Soler, Maria Gamissans, Marta Lara, A Ribera, M Romaní, Jorge Riera-Martí, Núria Pell - Necrosi Psoriasi Medicaments dermatològics CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Peptides::Intercellular Signaling Peptides and Proteins::Cytokines::Tumor Necrosis Factors CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors DISEASES::Skin and Connective Tissue Diseases::Skin Diseases::Skin Diseases, Papulosquamous::Psoriasis COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::péptidos::péptidos y proteínas de señalización intercelular::citocinas::factores de necrosis tumoral ENFERMEDADES::enfermedades de la piel y tejido conjuntivo::enfermedades de la piel::enfermedades cutáneas papuloescamosas::psoriasis COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::factores inmunitarios Tumor necrosis; Inhibitor therapy; Paradoxical reaction Necrosis tumoral; Tratamiento con inhibidores; Reacción paradójica Necrosi tumoral; Tractament amb inhibidors; Reacció paradoxal Background: Tumor necrosis factor α (TNF) inhibitors are used to treat different inflammatory diseases. Although these biologics have an adequate safety profile, they have been associated with paradoxical reactions. Material and methods: Retrospective review of patients on TNF inhibitor therapy who developed a paradoxical skin reaction and were seen at the dermatology department of Hospital Universitari Parc Taulí in Sabadell, Spain. Results: We collected data on 30 patients under treatment with a TNF inhibitor who developed an immune-mediated skin reaction in the form of psoriasis (90%), alopecia (6.7%), or neutrophilic dermatitis (3.3%). The most common drugs involved were adalimumab (56.7%) and infliximab (40%). Psoriasiform reactions mostly manifested as generalized plaques (62.9%) or palmoplantar pustulosis (37%). Thirteen patients (43.3%) continued on the same TNF inhibitor and 12 of them (92.3%) achieved partial or complete resolution of lesions. Five patients were switched to a different TNF inhibitor, but none of them achieved complete resolution. Eight patients were switched to a biologic with a different target, and 5 of them (62.5%) achieved partial or complete resolution. Conclusions: Paradoxical reactions during TNF inhibitor therapy do not always require a change of treatment. In our series, the addition of a topical and/or systemic treatment resolved the skin lesions in more than half of the patients, and switching to a drug with a different target was more effective. A change of strategy should be contemplated in more serious cases. 2025-10-24T11:00:14Z 2025-10-24T11:00:14Z 2024-02-09T11:57:09Z 2024-02-09T11:57:09Z 2024-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/11015 Actas Dermo-Sifiliográficas;115(1) https://doi.org/10.1016/j.ad.2023.06.016 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess Elsevier Scientia