Cutaneous vasculitis induced by TNF inhibitors: a report of three cases

Vol.20 No.1

Case Report

Cutaneous vasculitis induced by TNF inhibitors: a report of three cases

Authors

Keita Fujikawa¹ , Atsushi Kawakami¹ , Tomayoshi Hayashi² , Naoki Iwamoto¹ , Shin-ya Kawashiri¹ , Toshiyuki Aramaki¹ , Kunihiro Ichinose¹ , Mami Tamai¹ , Kazuhiko Arima¹ , Makoto Kamachi¹ , Satoshi Yamasaki¹ , Hideki Nakamura¹, Hiroaki Ida¹, Tomoki Origuchi³, Katsumi Eguchi¹

Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Department of Pathology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Nagasaki University School of Health Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan

Received:

1 April 2009

Accepted:

31 August 2009

Published online:

8 October 2009

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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.

Key words

TNF inhibitors - Infliximab - Etanercept - Cutaneous vasculitis - Leukocytoclastic vasculitis