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Rash induced by anti-tumor necrosis factor agents in an adolescent with Crohn's disease
Laurie S Conklin1, Bernard Cohen, Lindsay Wilson
1Division of Gastroenterology and Nutrition, Children's National Medical Center, 111 Michigan Avenue NW, West Wing 2.5, Suite 600, Washington DC 20010, USA.
Background:
A 17-year-old white male with Crohn's disease who was receiving maintenance infusions of the anti-tumor necrosis factor (TNF) agent, infliximab, presented with a new-onset psoriasiform skin rash. The rash was not responsive to topical or oral corticosteroids and worsened after infliximab infusions and after subsequent administration of a second anti-TNF drug, adalimumab.
Investigations:
Full medical history and physical examination, including assessment of the morphology of rash and the temporal correlation with administration of anti-TNF agents.
Diagnosis:
Anti-TNF-agent induced psoriasiform skin rash.
Management:
Discontinuation of anti-TNF therapy. The patient opted to have his gastrointestinal symptoms treated with oral mesalazine and metronidazole.
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