PMID- 30576759
OWN - NLM
STAT- MEDLINE
DCOM- 20210423
LR  - 20210423
IS  - 1097-6787 (Electronic)
IS  - 0190-9622 (Linking)
VI  - 83
IP  - 6
DP  - 2020 Dec
TI  - TNF-alpha inhibitor-induced psoriasis: A decade of experience at the Cleveland 
      Clinic.
PG  - 1590-1598
LID - S0190-9622(18)33089-5 [pii]
LID - 10.1016/j.jaad.2018.12.018 [doi]
AB  - BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) inhibitor (TNFI)-induced psoriasis 
      remains poorly understood despite having been described 15 years ago. As TNFIs 
      often provide life-changing patient benefits, understanding effective treatments 
      for TNFI-induced psoriasis is important. OBJECTIVE: We characterized a cohort of 
      patients with TNFI-induced psoriasis whose psoriasis was specifically diagnosed 
      and managed or comanaged by dermatologists at a single tertiary care institution 
      over a 10-year period. METHODS: Retrospective review of patients in whom 
      TNFI-induced psoriasis was diagnosed between 2003 and 2013. RESULTS: A total of 
      102 patients with TNFI-induced psoriasis were identified. The mean age of onset 
      was 40 years, and there was a female predominance (73.5%). Crohn's disease (in 
      48% of cases) and rheumatoid arthritis (in 24.5% of cases) were the most common 
      primary conditions. Infliximab (in 52% of cases) was the most common inciting 
      agent. The most common TNFI-induced psoriasis subtypes were plaque-type psoriasis 
      (49.5%), scalp psoriasis (47.5%), and palmoplantar pustulosis (41%). Topical 
      medications alone improved or resolved TNFI-induced psoriasis in 63.5% of 
      patients, and cyclosporine and methotrexate (>10 mg weekly) were often effective 
      if topicals failed. Discontinuation of the inciting TNFI with or without other 
      interventions improved or resolved TNFI-induced psoriasis in 67% of refractory 
      cases, whereas switching TNFIs resulted in persistence or recurrence in 64%. 
      LIMITATIONS: Retrospective nature of the study and the fact that some patients 
      may have developed typical psoriasis unresponsive to TNFIs. CONCLUSION: Our study 
      cohort represents the largest single-institution cohort of patients with 
      TNFI-induced psoriasis diagnosed and managed or comanaged by dermatologists to 
      date. On the basis of our findings, we propose a treatment algorithm for 
      TNFI-induced psoriasis.
CI  - Copyright (c) 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. 
      All rights reserved.
FAU - Mazloom, Sean E
AU  - Mazloom SE
AD  - Cleveland Clinic, Cleveland, Ohio.
FAU - Yan, Di
AU  - Yan D
AD  - Cleveland Clinic, Cleveland, Ohio.
FAU - Hu, Jeffery Z
AU  - Hu JZ
AD  - Cleveland Clinic, Cleveland, Ohio.
FAU - Ya, Jason
AU  - Ya J
AD  - Cleveland Clinic, Cleveland, Ohio.
FAU - Husni, M Elaine
AU  - Husni ME
AD  - Cleveland Clinic, Cleveland, Ohio.
FAU - Warren, Christine B
AU  - Warren CB
AD  - Cleveland Clinic, Cleveland, Ohio.
FAU - Fernandez, Anthony P
AU  - Fernandez AP
AD  - Cleveland Clinic, Cleveland, Ohio. Electronic address: fernana6@ccf.org.
LA  - eng
PT  - Journal Article
DEP - 20181218
PL  - United States
TA  - J Am Acad Dermatol
JT  - Journal of the American Academy of Dermatology
JID - 7907132
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (TNF protein, human)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age of Onset
MH  - Aged
MH  - Aged, 80 and over
MH  - Antirheumatic Agents/*adverse effects
MH  - Arthritis, Rheumatoid/drug therapy/immunology
MH  - Child
MH  - Cyclosporine/administration & dosage
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/*administration & dosage
MH  - Inflammatory Bowel Diseases/drug therapy/immunology
MH  - Male
MH  - Methotrexate/administration & dosage
MH  - Middle Aged
MH  - Psoriasis/chemically induced/drug therapy/*epidemiology/immunology
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sex Factors
MH  - Spondylitis, Ankylosing/drug therapy/immunology
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors/immunology
MH  - Young Adult
OTO - NOTNLM
OT  - TNF-alpha inhibitor
OT  - TNF-alpha inhibitor-induced psoriasis
OT  - adverse reaction
OT  - drug-induced
OT  - palmplantar pustulosis
OT  - psoriasiform
OT  - psoriasis
EDAT- 2018/12/24 06:00
MHDA- 2021/04/24 06:00
CRDT- 2018/12/22 06:00
PHST- 2018/07/20 00:00 [received]
PHST- 2018/12/08 00:00 [revised]
PHST- 2018/12/10 00:00 [accepted]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2021/04/24 06:00 [medline]
PHST- 2018/12/22 06:00 [entrez]
AID - S0190-9622(18)33089-5 [pii]
AID - 10.1016/j.jaad.2018.12.018 [doi]
PST - ppublish
SO  - J Am Acad Dermatol. 2020 Dec;83(6):1590-1598. doi: 10.1016/j.jaad.2018.12.018. 
      Epub 2018 Dec 18.