Pityriasis Amiantacea: A Unique Presentation of Psoriasis Associated With Tumour Necrosis Factor-Alpha Inhibitor Therapy
September 2023
in “
Rheumatology advances in practice
”
TLDR A woman's rare scalp condition worsened after using a specific arthritis medication, suggesting such medications can sometimes trigger or aggravate psoriasis.
A 42-year-old woman with a 15-year history of rheumatoid arthritis (RA) developed pityriasis amiantacea (PA), a rare scalp condition characterized by thick, silvery scales that can lead to hair loss, after being treated with golimumab, a tumor necrosis factor-α (TNF-α) inhibitor. Despite various treatments, her condition, which also included impetiginized PA and otitis externa, improved only after discontinuing golimumab. This case suggests that TNF-α inhibitors can paradoxically induce or worsen psoriasis, a phenomenon observed in other cases with different anti-TNF-α agents. The pathogenesis of PA is not fully understood, but it may involve an imbalance in the cytokine environment due to the inhibition of TNF-α, which normally helps regulate inflammation and immune responses. This case emphasizes the importance of monitoring for cutaneous adverse reactions in patients receiving anti-TNF-α therapy.
