Psoriatic Skin Lesions and Tumor Necrosis Factor α Antagonist Therapy

New-onset psoriasis and psoriasiform dermatitis have been linked to the use of anti–tumor necrosis factor α (anti–TNF-α) therapy. The pathogenesis of this process is not fully understood, but it may involve an imbalance of cytokines, particularly interferons.

In a systematic literature review, the authors identified 104 patients who developed new psoriatic lesions after the introduction of anti–TNF-α therapy. Most were being treated for rheumatoid arthritis, spondyloarthropathies, or inflammatory bowel disease, but nine patients were being treated for psoriasis. New-onset skin lesions occurred in 87% of the patients; the rest of the lesions appeared to be exacerbations of previous psoriasis. The morphology was pustular in 52%, guttate in 15%…