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Cutaneous vasculitis induced by TNF inhibitors: a report of three cases
Authors:Keita Fujikawa  Atsushi Kawakami  Tomayoshi Hayashi  Naoki Iwamoto  Shin-ya Kawashiri  Toshiyuki Aramaki  Kunihiro Ichinose  Mami Tamai  Kazuhiko Arima  Makoto Kamachi  Satoshi Yamasaki  Hideki Nakamura  Hiroaki Ida  Tomoki Origuchi  Katsumi Eguchi
Affiliation:1. Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
2. Department of Pathology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
3. Nagasaki University School of Health Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
Abstract:
We describe 3 rheumatoid arthritis (RA) patients with anti-tumor necrosis factor (TNF) therapy-induced cutaneous vasculitis. Two cases were induced by infliximab and the other, in whom cutaneous vasculitis was found early at the start of therapy, was induced by etanercept. Skin biopsy was obtained in 2 patients, with histology-proven leukocytoclastic vasculitis. One patient spontaneously improved after cessation of the TNF inhibitor. Two patients required oral corticosteroid, the efficacy of which was observed to be excellent and rapid.
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