Tocilizumab is a humanized monoclonal antibody to the interleukin-6 (IL-6) receptor which was first approved for use in refractory rheumatoid arthritis almost a decade ago. Since then, its use has expanded to a number of rheumatological and inflammatory conditions. In dermatology, off-label use of tocilizumab has been reported to be efficacious in morphoea, systemic sclerosis, psoriasis, atopic dermatitis, vitiligo, graft-versus-host disease, pyoderma gangrenosum, Behcet's disease, Schnitzler's syndrome, sarcoidosis, and cutaneous adverse reactions. That being said, the evidence demonstrating tocilizumab's efficacy in dermatology is predominantly low-level case-based evidence, and one must consider the potential for publication bias. In this review we will discuss the reported clinical applications of tocilizumab in dermatology, mechanisms of action, and the range of associated adverse effects (both cutaneous and non-cutaneous) that can occur. Additionally, we will discuss the role of tocilizumab in the management of COVID-19.
Keywords: COVID-19; IL-6; Tocilizumab; biologics; dermatology.
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