Saedpanah Roya, Rashidi Atiye, Firooz Alireza
Center for Research and Training in Skin Diseases and Leprosy (CRTSDL), Tehran University of Medical Sciences, Tehran, Iran.
Clin Cosmet Investig Dermatol. 2025 Sep 4;18:2183-2188. doi: 10.2147/CCID.S546208. eCollection 2025.
Psoriasis is a chronic inflammatory skin disorder that can significantly impact quality of life. Biologic therapies, such as TNF-alpha inhibitors, have improved clinical outcomes but may rarely cause hematologic abnormalities, including eosinophilia. Eosinophilia is uncommon but can be associated with allergic reactions or organ involvement.
We report a 33-year-old male with psoriasis and psoriatic arthritis who developed asymptomatic marked eosinophilia after eight doses of biosimilar adalimumab (CinnoRA). Baseline peripheral blood eosinophil percentage was 3.2%, which increased to 19.9% during therapy. Alternative causes, including parasitic infection, allergy, and hematologic disease, were excluded. CinnoRA was discontinued, and eosinophil counts normalized during follow-up.
This case illustrates that unexplained eosinophilia can occur during TNF-alpha inhibitor therapy. While routine monitoring is not universally recommended based on a single case, clinicians should consider eosinophilia as a possible adverse reaction, especially in symptomatic patients or those with persistently elevated counts.
银屑病是一种慢性炎症性皮肤病，会对生活质量产生重大影响。生物疗法，如肿瘤坏死因子-α抑制剂，改善了临床疗效，但可能很少引起血液学异常，包括嗜酸性粒细胞增多。嗜酸性粒细胞增多并不常见，但可能与过敏反应或器官受累有关。
我们报告一名33岁患有银屑病和银屑病关节炎的男性，在使用八剂生物类似药阿达木单抗（CinnoRA）后出现无症状的明显嗜酸性粒细胞增多。基线外周血嗜酸性粒细胞百分比为3.2%，在治疗期间增至19.9%。排除了包括寄生虫感染、过敏和血液系统疾病在内的其他病因。停用CinnoRA后，嗜酸性粒细胞计数在随访期间恢复正常。
该病例表明，在肿瘤坏死因子-α抑制剂治疗期间可能出现不明原因的嗜酸性粒细胞增多。虽然基于单个病例并不普遍推荐常规监测，但临床医生应将嗜酸性粒细胞增多视为可能的不良反应，尤其是在有症状的患者或计数持续升高的患者中。
