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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.

The document described 5 cases of anti-TNF-α induced psoriasiform eruptions with severe scalp involvement leading to inflammatory alopecia. Topical therapy was effective in only 1 case, while the other 4 required systemic therapy (methotrexate ± cyclosporine). Among these, 3 patients discontinued anti-TNF-α treatment, resulting in 2 achieving clear/almost clear status and 1 showing mild improvement; the fourth patient switched anti-TNF-α but continued to experience flare-ups. No scarring alopecia was observed in these cases. A review of 15 total cases in the literature indicated that 9 patients discontinued anti-TNF-α and 9 received systemic therapy, with 2 developing scarring alopecia. The study concluded that while some patients may respond to topical treatment, severe cases should consider anti-TNF-α suspension and systemic therapy to prevent scarring alopecia.

The study investigated weight gain and hair loss as adverse effects of anti-TNF therapy in 150 patients with rheumatic diseases. Weight gain was observed in 20 patients (13.3%) with an average gain of 5.5 kg, leading to discontinuation of therapy in five cases. Hair loss was reported in five females (3.3%), and all discontinued the therapy. The findings suggested that weight gain and hair loss were associated with anti-TNF therapy and could be reasons for stopping the treatment.