Anti-TNF-Related Leukocytoclastic Vasculitis in Ulcerative Colitis: A Case Report

Int J Environ Res Public Health. 2021 Jun 22;18(13):6711. doi: 10.3390/ijerph18136711.

Abstract

Background: The development of drugs directed against tumor necrosis factor (TNF)-α has dramatically modified the therapeutic approach to inflammatory bowel diseases: a larger use of such drugs has also led to a major knowledge about their adverse effects, especially on skin. The aim of this report was to describe a rare steroid-dependent form of leukocytoclastic vasculitis induced by an anti-TNF-α agent in a young woman with ulcerative colitis.

Case presentation: A young girl with ulcerative colitis developed a form of leukocytoclastic vasculitis induced by an anti-TNF-α agent. Recurrent palpable purpuric lesions on her legs were the main cutaneous manifestation. Skin lesions were steroid-dependent, but improved after withdrawal of the anti-TNF-α agent and second-line immunosuppressant therapy.

Conclusions: The need to develop specific recommendations to guide the use of medications for managing skin reactions induced by anti-TNF-α drugs is herein emphasized.

Keywords: leukocytoclastic vasculitis; purpura; tumor necrosis factor; ulcerative colitis.

Publication types

  • Case Reports

MeSH terms

  • Colitis, Ulcerative* / chemically induced
  • Colitis, Ulcerative* / drug therapy
  • Female
  • Humans
  • Tumor Necrosis Factor Inhibitors
  • Tumor Necrosis Factor-alpha
  • Vasculitis, Leukocytoclastic, Cutaneous* / chemically induced
  • Vasculitis, Leukocytoclastic, Cutaneous* / drug therapy

Substances

  • Tumor Necrosis Factor Inhibitors
  • Tumor Necrosis Factor-alpha

Supplementary concepts

  • Erythema elevatum diutinum