Eruptions in Patients Treated with TNF-α Antagonists

Rarely, patients treated with anti-tumor necrosis factor-α (anti-TNF-α) agents develop eruptions that resemble psoriasis. Most of these patients are being treated for rheumatoid arthritis, Crohn disease, ankylosing spondylitis, or, occasionally, psoriatic arthritis. Usually, they have no history of skin disease. The eruptions are apt to appear as pustular lesions with a predilection for the palms and soles. The pathogenesis of these eruptions and their relation to specific agents are not fully understood. Some patients have been successfully re-treated with the same agent without further eruptions, some received alternative anti-TNF-α agents without eruptions, and some developed similar eruptions after treatment with substitute anti-TNF-α a…