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Tumor necrosis factor-α (TNF-α) antagonists, long approved for Crohn disease and ulcerative colitis, are also prescribed for other rheumatologic, autoinflammatory, and dermatologic conditions. Most studies used to gain drug approval are relatively short-term. Development of psoriasis-like processes began to be reported years after widespread use of TNF antagonists. Several theories attempt to explain the development of such lesions, but the exact pathogenesis is not known. Most of these adverse reactions were not noted at the time these drugs were studied for approval.
These investigators studied 917 patients receiving TNF antagonists for inflammatory bowel disease (IBD) over 0.5 to 7 years. Of these patients, 264 (29%) developed skin lesion…