Infliximab-induced discoid lupus erythematosus

Area of Science:

• Immunology
• Dermatology
• Rheumatology

Background:

• Anti-tumor necrosis factor-alpha (TNF-α) therapies are standard for inflammatory conditions like rheumatoid arthritis.
• Infliximab, a TNF-α inhibitor, targets both soluble and transmembrane forms of the cytokine.
• Cutaneous side effects of TNF-α inhibitors are known, though rare.

Observation:

• A patient with rheumatoid arthritis developed a discoid lupus erythematosus-like eruption during infliximab treatment.
• The characteristic skin lesions appeared after initiating infliximab therapy.
• The eruption resolved upon cessation of infliximab.

Findings:

• This case highlights a rare discoid lupus erythematosus-like eruption associated with infliximab use in rheumatoid arthritis.
• Clinical, serological, and immunohistochemical findings support the diagnosis and link to infliximab.
• The adverse skin reaction demonstrated a clear temporal relationship with infliximab administration and withdrawal.

Implications:

• Physicians should be vigilant for rare cutaneous side effects in patients receiving infliximab for rheumatoid arthritis.
• Discontinuation of infliximab may be an effective strategy for managing this specific adverse eruption.
• Further research into the mechanisms of TNF-α inhibitor-induced dermatoses is warranted.