Moustou Aikaterini-Evaggelia, Matekovits Athina, Dessinioti Clio, Antoniou Christina, Sfikakis Petros P, Stratigos Alexander J
1st Department of Dermatology, Andreas Sygros Hospital, University of Athens Medical School, Athens, Greece.
J Am Acad Dermatol. 2009 Sep;61(3):486-504. doi: 10.1016/j.jaad.2008.10.060. Epub 2009 Jul 22.
Anti-tumor necrosis factor (anti-TNF) biologic agents have been associated with a number of adverse events.
To review the cutaneous reactions that have been reported in patients receiving anti-TNF therapy.
We performed a systematic MEDLINE search of relevant publications, including case reports and case series.
Reported cutaneous events included infusion and injection site reactions, psoriasiform eruptions, lupus-like disorders, vasculitis, granulomatous reactions, cutaneous infections, and cutaneous neoplasms. Infusion reactions and injection site reactions were definitely associated with anti-TNF administration, whereas all other events had a varying strength of association and severity, not necessarily requiring drug discontinuation.
Most information was derived from spontaneous case reports, where ascertainment biases and frequency of reporting may impair detection methodology and causal relationships.
As anti-TNF biologic agents are progressively being used in clinical practice, cutaneous adverse events will be encountered more frequently. Until more data are accumulated with respect to their pathogenesis and potential association with anti-TNF therapy, dermatologists should become more familiar with the clinical presentation and management of such events.
抗肿瘤坏死因子（抗TNF）生物制剂与多种不良事件相关。
回顾接受抗TNF治疗患者中报告的皮肤反应。
我们对相关出版物进行了系统的MEDLINE检索，包括病例报告和病例系列。
报告的皮肤事件包括输注和注射部位反应、银屑病样皮疹、狼疮样疾病、血管炎、肉芽肿反应、皮肤感染和皮肤肿瘤。输注反应和注射部位反应肯定与抗TNF给药有关，而所有其他事件的关联强度和严重程度各不相同，不一定需要停药。
大多数信息来自自发的病例报告，其中确定偏倚和报告频率可能会损害检测方法和因果关系。
随着抗TNF生物制剂在临床实践中的逐渐应用，皮肤不良事件将更频繁地出现。在积累更多关于其发病机制以及与抗TNF治疗潜在关联的数据之前，皮肤科医生应更熟悉此类事件的临床表现和管理。
