TY - JOUR
T1 - Disseminated granuloma annulare
T2 - A cutaneous adverse effect of anti-TNF agents
AU - Ratnarathorn, Mondhipa
AU - Raychaudhuri, Siba P
AU - Naguwa, Stanley M
PY - 2011/11
Y1 - 2011/11
N2 - Tumor necrosis factor-alpha (TNF-) inhibitors, such as etanercept, infliximab, and adalimumab, bind to TNF- and thereby act as anti-inflammatory agents. This group of drugs has been approved for the treatment of rheumatoid arthritis, psoriatic arthritis, moderate to severe plaque psoriasis, ankylosing spodylitis, Crohn disease, and juvenile idiopathic arthritis. We describe a 56-year-old woman who developed an erythematous pruritic rash on both arms-diagnosed as granuloma annulare by skin biopsy-approximately 22 months after initiating adalimumab for treatment of rheumatoid arthritis. On stopping adalimumab there was total clearance of the skin lesions, but a similar rash developed again when her treatment was switched to another anti-TNF agent (etanercept). This clinical observation supports a link between TNF inhibition and the development of granuloma annulare.
AB - Tumor necrosis factor-alpha (TNF-) inhibitors, such as etanercept, infliximab, and adalimumab, bind to TNF- and thereby act as anti-inflammatory agents. This group of drugs has been approved for the treatment of rheumatoid arthritis, psoriatic arthritis, moderate to severe plaque psoriasis, ankylosing spodylitis, Crohn disease, and juvenile idiopathic arthritis. We describe a 56-year-old woman who developed an erythematous pruritic rash on both arms-diagnosed as granuloma annulare by skin biopsy-approximately 22 months after initiating adalimumab for treatment of rheumatoid arthritis. On stopping adalimumab there was total clearance of the skin lesions, but a similar rash developed again when her treatment was switched to another anti-TNF agent (etanercept). This clinical observation supports a link between TNF inhibition and the development of granuloma annulare.
KW - Adverse effect
KW - anti-TNF therapy
KW - granuloma annulare
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U2 - 10.4103/0019-5154.91847
DO - 10.4103/0019-5154.91847
M3 - Article
C2 - 22345789
AN - SCOPUS:84856380105
VL - 56
SP - 752
EP - 754
JO - Indian Journal of Dermatology
JF - Indian Journal of Dermatology
SN - 0019-5154
IS - 6
ER -