[Paradoxical skin reactions under therapy with TNF-alpha antagonists]

Tumor necrosis factor α (TNF α) antagonists are an effective and established therapy option for chronic inflammatory diseases in rheumatology, gastroenterology and dermatology. However, some undesired but rare side effects of TNF α antagonists, so-called paradoxical skin reactions, have been observed. These are mostly in the form of psoriasiform skin alterations, including pustular variants, eczema, vasculitis and other rare skin diseases. This article provides an overview of the different variants of paradoxical skin reactions due to TNF α inhibitors and gives practical advice on the therapeutic consequences.