Anti-TNF Antibody-Induced Psoriasiform Skin Lesions in Patients with Inflammatory Bowel Disease Are Characterised by Interferon-γ-Expressing Th1 Cells and IL-17A/IL-22-Expressing Th17 Cells and Respond to Anti-IL-12/IL-23 Antibody Treatment

    March 2013 in “ Gut ”
    Cornelia Tillack, Laura Maximiliane Ehmann, Matthias Friedrich, Rüdiger P. Laubender, Pavol Papay, Harald Vogelsang, Johannes Stallhofer, Florian Beigel, Andrea Bedynek, Martin Wetzke, Harald Maier, Maria Koburger, Judith Wagner, Jürgen Glas, Julia Diegelmann, Sarah Koglin, Yvonne Dombrowski, Jürgen Schauber, Andreas Wollenberg, Stephan Brand
    In this study, 434 patients with inflammatory bowel disease (IBD) treated with anti-TNF-α antibodies were screened for psoriasiform skin lesions, with 21 (4.8%) developing such lesions. Smoking and increased body mass index were identified as significant predictors. Histological analysis revealed infiltrates of Th1 and Th17 cells in the lesions. Nine patients with severe lesions or anti-TNF-induced alopecia were treated with the anti-IL-12/IL-23 antibody ustekinumab, achieving a 100% response rate. The severity of lesions correlated with the number of IL-17A-expressing T cells. The study concluded that anti-IL-12/IL-23 antibody therapy is highly effective for treating these lesions.
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