Cutaneous vasculitis induced by TNF inhibitors: a report of three cases

Mod Rheumatol. 2010 Feb;20(1):86-9. doi: 10.1007/s10165-009-0232-7. Epub 2009 Oct 8.

Abstract

We describe 3 rheumatoid arthritis (RA) patients with anti-tumor necrosis factor (TNF) therapy-induced cutaneous vasculitis. Two cases were induced by infliximab and the other, in whom cutaneous vasculitis was found early at the start of therapy, was induced by etanercept. Skin biopsy was obtained in 2 patients, with histology-proven leukocytoclastic vasculitis. One patient spontaneously improved after cessation of the TNF inhibitor. Two patients required oral corticosteroid, the efficacy of which was observed to be excellent and rapid.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antirheumatic Agents / adverse effects*
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy*
  • Drug Therapy, Combination
  • Etanercept
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin G / adverse effects*
  • Infliximab
  • Middle Aged
  • Receptors, Tumor Necrosis Factor
  • Skin / drug effects
  • Skin / pathology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Vasculitis, Leukocytoclastic, Cutaneous / chemically induced*
  • Vasculitis, Leukocytoclastic, Cutaneous / drug therapy
  • Vasculitis, Leukocytoclastic, Cutaneous / pathology

Substances

  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Glucocorticoids
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha
  • Infliximab
  • Etanercept