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Rash induced by anti-tumor necrosis factor agents in an adolescent with Crohn's disease

Nature Reviews Gastroenterology & Hepatology volume 7, pages 174–177 (2010)Cite this article

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Abstract

Background. A 17-year-old white male with Crohn's disease who was receiving maintenance infusions of the anti-tumor necrosis factor (TNF) agent, infliximab, presented with a new-onset psoriasiform skin rash. The rash was not responsive to topical or oral corticosteroids and worsened after infliximab infusions and after subsequent administration of a second anti-TNF drug, adalimumab.

Investigations. Full medical history and physical examination, including assessment of the morphology of rash and the temporal correlation with administration of anti-TNF agents.

Diagnosis. Anti-TNF-agent induced psoriasiform skin rash.

Management. Discontinuation of anti-TNF therapy. The patient opted to have his gastrointestinal symptoms treated with oral mesalazine and metronidazole.

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Figure 1: Diffuse, erythematous, annular patches with areas of confluence can be seen extending across the trunk in this 17-year-old adolescent, following treatment with infliximab.
Figure 2

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Acknowledgements

Written consent for publication was obtained from the patient.

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Authors and Affiliations

  1. Division of Gastroenterology and Nutrition, Children's National Medical Center, 111 Michigan Avenue NW, West Wing 2.5, Suite 600, Washington, 20010, DC, USA

    Laurie S. Conklin

  2. Division of Pediatric Dermatology, David M. Rubenstein Child Health Building, Suite 2107, 200 North Wolfe Street, Baltimore, 21287, MD, USA

    Bernard Cohen

  3. Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins University School of Medicine, Brady 320, 600 North Wolfe Street, Baltimore, 21205, MD, USA

    Lindsay Wilson, Carmen Cuffari & Maria Oliva-Hemker

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  1. Laurie S. Conklin
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Corresponding author

Correspondence to Maria Oliva-Hemker.

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Competing interests

Bernard Cohen reports receiving support for a CME program from Centocor. Lindsay Wilson reports receiving research support from UCB. Maria Oliva-Hemker reports receiving research support from Centocor and Abbott Immunology. The other authors declare no competing interests.

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Conklin, L., Cohen, B., Wilson, L. et al. Rash induced by anti-tumor necrosis factor agents in an adolescent with Crohn's disease. Nat Rev Gastroenterol Hepatol 7, 174–177 (2010). https://doi.org/10.1038/nrgastro.2010.7

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