Amicrobial pustulosis of the folds and palmoplantar pustulosis simultaneously induced by different tumor necrosis factor-α inhibitors: Demonstration of a shared pathophysiology
نویسندگان
چکیده
APF: amicrobial pustulosis of the folds IBD: inflammatory bowel disease IFN-a: interferon-a PPP: palmoplantar pustulosis TNF-a: tumor necrosis factor-a INTRODUCTION Amicrobial pustulosis of the folds (APF) and palmoplantar pustulosis (PPP) are 2 rare autoinflammatory neutrophilic dermatoses. Many studies report PPP triggered by treatment of inflammatory bowel disease (IBD) with tumor necrosis factor-a (TNF-a) blockers. APF is much rarer and predominantly affects young women with autoimmune conditions. Both conditions share histologic features of superficial spongiform pustulation associated with perivascular neutrophilic infiltration, without evidence of infection or vasculitis. The clinical differentiation of these disorders is largely based on anatomic location. APF commonly occurs on cutaneous folds of the skin, the scalp, and the periorificial areas of the head. PPP, as the name suggests, primarily occurs on the palms and soles. These 2 conditions are currently considered separate entities. TNF-a blockers are used in a variety of diseases, notably IBD, psoriasis, and rheumatoid arthritis. Pustular reactions, whether PPP or APF, occur in less than 1% of patients treated with TNF-a inhibitors. We report a novel case of APF and PPP occurring and relapsing together in a patient after treatment with adalimumab and certolizumab.
منابع مشابه
Paradoxical Autoinflammatory Skin Reaction to Tumor Necrosis Factor Alpha Blockers Manifesting as Amicrobial Pustulosis of the Folds in Patients With Inflammatory Bowel Diseases
The therapy of inflammatory bowel disease, particularly with tumor necrosis factor (TNF) blockers, may be associated with a number of cutaneous adverse effects, including psoriasis-like, eczema-like, and lichenoid eruptions. Other rare skin complications are neutrophilic dermatoses such as amicrobial pustulosis of the folds (APF), which is a chronic relapsing pustular disorder classified in thi...
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Autoinflammation has recently been suggested in the pathogenesis of neutrophilic dermatoses but systematic studies on their cytokine profile are lacking. Notably, amicrobial pustulosis of the folds (APF), classified among neutrophilic dermatoses, has been studied only in small case series. In our University Hospital, we conducted an observational study on 15 APF patients, analyzing their clinic...
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Despite, the fact that palmoplantar pustulosis is still widely known by this name, it is currently regarded as a disease distinct from psoriasis. The real cause is still unknown. Septic foci have been blamed, but their removal may not cure eruptions. A case series of de novo occurrence of palmoplantar pustulosis induced by tumor necrosis factor–alpha antagonist therapy has been reported. It has...
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