Anonymous User
Login / Registration

a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2019; 73(6): 496–500. doi:10.14735/amgh2019496.

Anti-TNF alpha-induced immune-mediated skin adverse reactions resolved by switching to ustekinumab

Karolína Vorčáková1, Marta Horáková2, Juraj Péč1

+ Affiliation


Immune-mediated adverse reactions are a new group of conditions that develop during anti-TNF-alpha treatment. Their etiopathogenesis remains unclear. This study describes three forms of immune-mediated adverse reactions of the skin that were diagnosed correctly. Some types of immune-mediated adverse reactions, such as palmoplantar pustular psoriasis, may persist for a long time after switching biologic agents.


anti-TNF-alpha, cutaneous adverse effects, ustekinumab

To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users


1. Andrade P, Lopes S, Gaspar R et al. Anti-tumor necrosis factor-α-induced dermatological complications in a large cohort of inflammatory bowel disease patients. Dig Dis Sci 2018; 63 (3): 746–54. doi: 10.1007/s10620-018-4921-y.
2. Verea MM, Del Pozo J, Yebra-Pimentel MT et al. Psoriasiform eruption induced by infliximab. Ann Pharmacother 2004; 38 (1): 54–57. doi: 10.1345/aph.1C477.
3. Puig L. Paradoxical reactions: anti-tumor necrosis factor alpha agents, ustekinumab, secukinumab, ixekizumab, and others. Curr Probl Dermatology 2018; 53: 49–63. doi: 10.1159/ 000479475.
4. Vorčáková K, Juraj P, Péčová T et al. Immune-mediated skin reactions induced by recombinant antibodies and other TNF-alpha inhibitors. [online]. Available from: https: //
5. Ciccarelli F, De Martinis M, Sirufo MM et al. Psoriasis induced by anti-tumor necrosis factor alpha agents: a comprehensive review of the literature. Acta Dermatovenerol Croat 2016; 24 (3): 169–174.
6. Collamer AN, Battafarano DF. Psoriatic skin lesions induced by tumor necrosis factor antagonist therapy: clinical features and possible immunopathogenesis. Semin Arthritis Rheum 2010; 40 (3): 233–240. doi: 10.1016/ j.semarthrit.2010.04.003.
7. Vinkel C, Thomsen SF. Autoinflammatory syndromes associated with hidradenitis suppurativa and/or acne. Int J Dermatol 2017; 56 (8): 811–818. doi: 10.1111/ijd.13603.
8. Vorcakova K, Pecova T, Turonova L. Anti-dsDNA antibodies and their association with paradoxical psoriasis induced by TNF alfa inhibitors. Bratislava Lek Listy 2017; 118 (4): 250–250. doi: 10.4149/BLL_2017_049.
9. Wendling D, Prati C. Paradoxical effects of anti-TNF-α agents in inflammatory diseases. Expert Rev Clin Immunol 2014; 10 (1): 159–169. doi: 10.1586/1744666X.2014.866038.

Kreditovaný autodidaktický test