Infliximab-induced discoid lupus erythematosus

Abstract

Anti-tumor necrosis factor-alpha (TNF-α) immunotherapy is currently used in the treatment of various inflammatory diseases such as rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis and Crohn’s disease. Infliximab is a chimeric monoclonal antibody that binds to transmembrane-bound and soluble TNF-α. Previously, a discoid lupus erythematosus-like eruption linked to its use was rarely reported in patients with rheumatoid arthritis. We present a case of rheumatoid arthritis which developed such an eruption after treatment with infliximab. The lesions resolved after the discontinuation of infliximab. In the present case, the clinical, serological and immunohistochemical features of our patient are discussed with the literature.

Keywords

Anti-tumor necrosis factor therapies lupus syndrome rheumatoid arthritis

Get full access to this article

View all access options for this article.

References

Moustou AE, Matekovits A, Dessinioti C, et al. Cutaneous side effects of anti-tumor necrosis factor biologic therapy: A clinical review. J Am Acad Dermatol 2009; 61: 486–504.

Exarchou SA, Voulgari PV, Markatseli TE, et al. Immunemediated skin lesions in patients treated with anti-tumour necrosis factor alpha inhibitors. Scand J Rheumatol 2009; 38: 328–331.

Debandt

Vittecoq

Descamps

. Anti-TNF-alpha-induced systemic lupus syndrome. Clin Rheumatol 2003; 22: 56–61.

Takahashi H, Kaneta K, Honma M, et al. Sarcoidosis during infliximab therapy for Crohn’s disease. J Dermatol 2010; 37: 471–474.

Spillane AP, Xia Y, Sniezek PJ. Drug-induced lupus erythematosus in a patient treated with adalumimab. J Am Acad Dermatol 2007; 56: 114–116.

Favalli

Sinigaglia

Varenna

. Drug-induced lupus following treatment with infliximab in rheumatoid arthritis. Lupus 2002; 11: 753–755.

Gupta AK, Skinner AR. A review of the use of infliximab to manage cutaneous dermatoses. J Cutan Med Surg 2004; 8: 77–89.

Stratigos AJ, Antoniou C, Stamathioudaki S, et al. Discoid lupus erythematosus-like eruption induced by infliximab. Clin Exp Dermatol 2004; 29: 150–153.

Wetter DA, Davis MD. Lupus-like syndrome attributable to antitumor necrosis factor alpha therapy in 14 patients during an 8-year period at Mayo Clinic. Mayo Clin Proc 2009; 84: 979–984.

10.

Aringer M, Smolen JS. The role of tumor necrosis factor-alpha in systemic lupus erythematosus. Arthritis Res Ther 2008; 10: 202–210.

11.

Pallotta P, Cianchini G, Ruffelli M, et al. Infliximab-induced lupus-like reaction in a patient with psoriatic arthritis. Rheumatology (Oxford) 2006; 45: 116–117.

12.

Shakoor N, Michalska M, Harris CA, et al. Drug-induced systemic lupus erythematosus associated with etanercept therapy. Lancet 2002; 359: 579–580.

13.

Brion PH, Mittal-Henkle A, Kalunian KC. Autoimmune skin rashes associated with etanercept for rheumatoid arthritis. Ann Intern Med 1999; 131: 634.

14.

Misery L, Perrot JL, Gentil-Perret A, et al. Dermatological complications of etanercept therapy for rheumatoid arthritis. Br J Dermatol 2002; 146: 334–335.

15.

Gonnet-Gracia C, Barnetche T, Richez C, et al. Anti-nuclear antibodies, anti-DNA and C4 complement evolution in rheumatoid arthritis and ankylosing spondylitis treated with TNF-alpha blockers. Clin Exp Rheumatol 2008; 26: 401–407.

16.

Lorenz HM, Herrmann M, Winkler T, et al. Role of apoptosis in autoimmunity. Apoptosis 2000; 5: 443–449.

17.

Eriksson C, Engstrand S, Sundqvist KG, et al. Autoantibody formation in patients with rheumatoid arthritis treated with anti-TNF alpha. Ann Rheum Dis 2005; 64: 403–407.

18.

Zheng L, Fisher G, Miller RE, et al. Induction of apoptosis in mature T cells by tumour necrosis factor. Nature 1995; 377: 348–351.

19.

Williams EL, Gadola S, Edwards CJ. Anti-TNF-induced lupus. Rheumatology (Oxford) 2009; 48: 716–720.