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Multiple bilateral eyelid molluscum contagiosum lesions associated with TNFalpha-antibody and methotrexate therapy
Claus Cursiefen1, Mathias Grunke, Claudia Dechant
1Department of Ophthalmology and University Eye Hospital Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. claus.cursiefen@augen.med.uni-erlangen.de
Purpose:
To demonstrate a patient developing multiple bilateral eyelid molluscum contagiosum lesions after initiation of TNFalpha-antibody therapy for rheumatoid arthritis.
Design:
Single interventional case report.
Methods:
Clinical, histopathologic, and immunologic-serological findings are presented.
Results:
A 67-year-old patient with a 5-year history of rheumatoid arthritis had been treated with prednisone and methotrexate for the last 5 years. After initiation of additional TNFalpha-antibody treatment, complaints from rheumatoid arthritis subsided, but multiple bilateral molluscum contagiosum lesions of upper and lower eyelids occurred despite normal or only slightly reduced CD(4) (420-178/ microl) and CD(8) counts (143-58/microl). Histopathologic evaluation of the excised warts confirmed the clinical diagnosis. Under continued therapy, the warts have been recurring for 12 months.
Conclusion:
TNFalpha-antibody treatment for rheumatoid arthritis may compromise the host response to molluscum contagiosum, especially if methotrexate is given additionally. Patients should be informed about this potential complication.
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