Tocilizumab-induced psoriatic eruption : a case report and a case-based review.

IF 3.2 3区医学 Q2 RHEUMATOLOGY Rheumatology International Pub Date : 2024-10-01 Epub Date: 2024-07-16 DOI:10.1007/s00296-024-05663-9

Hubert Nielly, L Bialé, L Gilardin, T Carmoi, A Éon, H Vanquaethem, A-C Fougerousse

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Abstract

Background: Cases of psoriasis associated with Tocilizumab (TCZ) are scarce.

Objective: To describe a new case of TCZ-associated psoriasis and to perform a case-based review of similar cases.

Methods: We searched Medline/Pubmed, Embase, Scopus, Web of Science, and Directory of Open Access Journals databases using the terms « Tocilizumab » and « Psoriasis » in the French and English literature.

Results: We report a 70-year-old woman with a history of Rheumatoid Arthritis who developed Infliximab-induced plaque psoriatic eruption of the soles and palms, that resolved after Infliximab interruption, then relapsed after TCZ relay, and eventually resolved after TCZ interruption. Including our case, we identified 16 cases of TCZ-induced psoriatic eruption. Three (21%) out of 14 patients had a history of cutaneous psoriasis - data were not available for 2 patients. Eight (50%) patients had previously received TNFα antagonists. TCZ was stopped for 10 patients and continued for 4 patients. For the 2 remaining patients, the interval between two injections of TCZ was shortened. All the patients with available follow-up data had an improvement of the eruption within 4 weeks.

Conclusion: To conclude, in case of TCZ-induced psoriatic eruption and in light of the published cases, we suggest using topical steroids and reassessing the patient 4 weeks later. If no healing is obtained, we suggest stopping TCZ, and treating the underlying disease with another drug. When no other drug is available, while waiting for more data regarding the value of IL-6 levels, it can be discussed to increase TCZ regimen, as it has been successful for 2 authors. Efficacy assessment of the chosen attitude should not take place before 4 weeks.

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托西珠单抗诱发的银屑病疹：病例报告和病例综述。

背景：与托昔单抗（TCZ）相关的银屑病病例很少：与Tocilizumab（TCZ）相关的银屑病病例很少：描述一例与TCZ相关的银屑病新病例，并对类似病例进行病例回顾：方法：我们使用 "Tocilizumab "和 "Psoriasis "这两个词对Medline/Pubmed、Embase、Scopus、Web of Science和Directory of Open Access Journals数据库中的法文和英文文献进行了检索：我们报告了一名 70 岁的女性患者，她有类风湿性关节炎病史，脚底和手掌出现英夫利昔单抗诱发的斑块状银屑病糜烂，英夫利昔单抗中断治疗后糜烂缓解，TCZ 中继治疗后糜烂复发，TCZ 中断治疗后糜烂最终缓解。包括我们的病例在内，我们共发现了16例TCZ诱发的银屑病糜烂。14例患者中有3例（21%）有皮肤银屑病病史，其中2例患者的数据不详。8名患者（50%）曾服用过TNFα拮抗剂。10名患者停用了TCZ，4名患者继续使用。其余2名患者两次注射TCZ的间隔时间缩短。所有有随访数据的患者均在 4 周内改善了糜烂情况：总之，根据已发表的病例，对于 TCZ 引起的银屑病糜烂，我们建议使用局部类固醇激素，并在 4 周后对患者进行重新评估。如果没有痊愈，我们建议停用 TCZ，并用其他药物治疗潜在疾病。在没有其他药物可用的情况下，在等待有关 IL-6 水平值的更多数据时，可以讨论增加 TCZ 方案，因为有两位作者的方案取得了成功。对所选方案的疗效评估不应在 4 周前进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology International 医学-风湿病学

CiteScore

7.30

自引率

5.00%

发文量

191

审稿时长

16. months

期刊介绍： RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.