Abstract
The tumor necrosis factor (TNF) blockers are highly effective therapy for numerous autoimmune inflammatory diseases, including rheumatoid arthritis, psoriatic arthropathy (PsA), spondyloarthropathies, juvenile idiopathic arthritis and inflammatory bowel disease. Paradoxically, these agents can induce cutaneous and systemic autoimmune diseases; the most common are psoriasis skin lesions and systemic lupus erythematosus (SLE) induced by TNF blockers. We present the case of a 59 years-old female, diagnosed at 32 years with cutaneous psoriasis vulgaris and psoriatic arthropathy at 54 years-old. After treatment failure with conventional Disease-Modifying Antirheumatic Drugs (DMARDs), biologic therapy with infliximab was started. After 3 years of treatment, the patient suffers an exacerbation of skin lesions and worsening joint damage. We decided to stop the infliximab and initiate the therapy with another anti-TNF agent (adalimumab), with improvement of the skin lesions and joint manifestations.
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