Immune-Mediated Skin Reactions Induced by Recombinant Antibodies and Other TNF-Alpha Inhibitors

February 2018 in “ InTech eBooks ”

Karolína Vorčáková, Péc J, Tatiana Péčová, Martinásková Klára

TNF-alpha inhibitors psoriasis lupus-like syndrome sarcoidosis alopecia areata vasculitis lichenoid reactions cytokine cascades IL-17 INF-alpha paradoxical psoriasis pyoderma gangrenosum morphea

TLDR TNF-alpha inhibitors can cause various immune-related skin issues.

Biologic agents inhibiting TNF-alpha have revolutionized treatment for chronic inflammatory diseases but have introduced new immune-mediated adverse effects. These effects, including psoriasis, lupus-like syndrome, sarcoidosis, alopecia areata, vasculitis, and lichenoid reactions, arise from disrupted cytokine cascades in genetically predisposed individuals. Theories suggest cross-reactions and cytokine dysregulation, particularly involving IL-17 and INF-alpha. Paradoxical reactions, such as paradoxical psoriasis, occur when the treatment induces the very conditions it aims to treat. Less common reactions include pyoderma gangrenosum and morphea.

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