PMID- 34409641
OWN - NLM
STAT- MEDLINE
DCOM- 20211103
LR  - 20211103
IS  - 1346-8138 (Electronic)
IS  - 0385-2407 (Linking)
VI  - 48
IP  - 11
DP  - 2021 Nov
TI  - Clinical background of patients with psoriasiform skin lesions due to tumor 
      necrosis factor antagonist administration at a single center.
PG  - 1745-1753
LID - 10.1111/1346-8138.16103 [doi]
AB  - Paradoxical reaction (PR) occurs when a drug elicits a reaction contrary to what 
      was expected. To clarify the clinical features and genetic background of 
      individuals susceptible to PR, we analyzed the clinical course of patients in 
      whom psoriatic eruptions worsened or newly developed during tumor necrosis factor 
      (TNF) antagonist administration and the role of focal infections and genetic 
      variations. Of 125 patients who received TNF antagonist therapy for psoriasis, 
      acrodermatitis continua of Hallopeau (ACH), generalized pustular psoriasis (GPP), 
      or palmoplantar pustular psoriasis (PPP), eight patients with PR were surveyed at 
      our hospital Dermatology Department between 2010 and 2021. A survey was also done 
      on six patients who received TNF antagonist therapy for Crohn's disease, 
      rheumatoid arthritis, ankylosing spondylitis, and hidradenitis suppurativa and 
      were referred to our department due to PR. Additionally, Sanger sequencing 
      analysis was performed for all exons and flanking introns of IL36RN (interleukin 
      36 receptor antagonist), CARD14 (caspase recruitment domain-containing protein 
      14), and AP1S3 (adaptor-related protein complex 1 subunit sigma 3). The clinical 
      assessment of the 14 patients demonstrated an average age at PR onset of 
      48.4 years, a male : female ratio of 5:9, and a mean administration period until 
      onset of 9.2 months. The clinical types of PR were plaque psoriasis, PPP, GPP, 
      pustulosis, acne, ACH, hair loss, and exacerbation of arthralgia. Histopathology 
      revealed psoriasiform dermatitis in three patients. One patient continued TNF 
      antagonist therapy. All of the patients with psoriasis and GPP had dental 
      infections, suggesting that focal infection may be a risk factor of the 
      development of PR following TNF antagonist therapy. Gene analysis demonstrated 
      CARD14 gene variants associated with RA, CD, AS, or PPP in four patients. In 
      addition, all of the patients with ACH and PPP experienced PR, suggesting that 
      these diseases may predispose patients to PR to TNF antagonist therapy.
CI  - (c) 2021 Japanese Dermatological Association.
FAU - Mori, Miho
AU  - Mori M
AUID- ORCID: 0000-0001-9923-5157
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
FAU - Tobita, Rie
AU  - Tobita R
AUID- ORCID: 0000-0002-2183-1503
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
FAU - Egusa, Chizu
AU  - Egusa C
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
FAU - Maeda, Tatsuo
AU  - Maeda T
AUID- ORCID: 0000-0002-6409-4443
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
FAU - Abe, Namiko
AU  - Abe N
AUID- ORCID: 0000-0003-3588-4099
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
FAU - Kawakami, Hiroshi
AU  - Kawakami H
AUID- ORCID: 0000-0002-3399-2611
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
FAU - Mae, Kenichiro
AU  - Mae K
AUID- ORCID: 0000-0002-8706-495X
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
FAU - Matsumoto, Yuka
AU  - Matsumoto Y
AUID- ORCID: 0000-0001-7429-5487
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
FAU - Kawachi, Yasuhiro
AU  - Kawachi Y
AUID- ORCID: 0000-0003-1106-9380
AD  - Department of Dermatology, Tokyo Medical University Ibaraki Medical Center, 
      Ibaraki, Japan.
FAU - Okubo, Yukari
AU  - Okubo Y
AUID- ORCID: 0000-0002-9526-1259
AD  - Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20210819
PL  - England
TA  - J Dermatol
JT  - The Journal of dermatology
JID - 7600545
RN  - 0 (CARD Signaling Adaptor Proteins)
RN  - 0 (IL36RN protein, human)
RN  - 0 (Interleukins)
RN  - 0 (Membrane Proteins)
RN  - 0 (Tumor Necrosis Factor Inhibitors)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - EC 4.6.1.- (CARD14 protein, human)
RN  - EC 4.6.1.2 (Guanylate Cyclase)
SB  - IM
MH  - *Arthritis, Rheumatoid
MH  - CARD Signaling Adaptor Proteins
MH  - *Crohn Disease
MH  - Female
MH  - Guanylate Cyclase
MH  - Humans
MH  - Interleukins
MH  - Male
MH  - Membrane Proteins
MH  - *Psoriasis/chemically induced/drug therapy/genetics
MH  - *Spondylitis, Ankylosing
MH  - Tumor Necrosis Factor Inhibitors
MH  - Tumor Necrosis Factor-alpha/genetics
OTO - NOTNLM
OT  - CARD14 variants
OT  - focal infections
OT  - paradoxical reaction
OT  - psoriasis
OT  - tumor necrosis factor antagonists
EDAT- 2021/08/20 06:00
MHDA- 2021/11/04 06:00
CRDT- 2021/08/19 07:01
PHST- 2021/06/30 00:00 [revised]
PHST- 2021/04/30 00:00 [received]
PHST- 2021/07/26 00:00 [accepted]
PHST- 2021/08/20 06:00 [pubmed]
PHST- 2021/11/04 06:00 [medline]
PHST- 2021/08/19 07:01 [entrez]
AID - 10.1111/1346-8138.16103 [doi]
PST - ppublish
SO  - J Dermatol. 2021 Nov;48(11):1745-1753. doi: 10.1111/1346-8138.16103. Epub 2021 
      Aug 19.