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Ann Rheum Dis 65:1529-1530 doi:10.1136/ard.2005.040576
  • Letter

Development of new-onset psoriasis while on anti-TNFα treatment

  1. C Matthews1,
  2. S Rogers2,
  3. O FitzGerald1
  1. 1Department of Rheumatology, St Vincent’s University Hospital, Dublin, Ireland
  2. 2Department of Dermatology, St Vincent’s University Hospital
  1. Correspondence to:
    C Matthews
    Department of Rheumatology, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland;matthews_clare{at}hotmail.com
  • Accepted 2 March 2006

Treatments directed against the proinflammatory cytokine tumour necrosis factor α (TNFα) are effective in rheumatoid arthritis and spondyloarthropathies. In patients with inflammatory arthritis secondary to psoriasis, chronic skin plaques also resolve with this treatment. We report on a series of clinical cases in which, conversely, there was a first presentation of psoriasis while on anti-TNF treatment.

The first case is that of a 49-year-old man with established ankylosing spondylitis, who was started on infliximab and showed an excellent response. After 8 months of treatment, he developed an erythematous, pustular rash over his back (fig 1). No clinical or serological evidence of infection was found and his medication, …