Rheumatology International

, Volume 25, Issue 7, pp 550–552

Pustular skin lesions in patients treated with infliximab: report of two cases

  • M. J. F. Starmans-Kool
  • H. R. M. Peeters
  • H. H. M. L Houben
Case Report


Two cases are presented in which repeated use of the TNF-α blocker infliximab may have led to development of pustular skin lesions. These findings might result in an improved understanding regarding the safety of infliximab with long-term usage.


Adverse events Infliximab Pustular psoriasis TNF-α blockers 


  1. 1.
    Keating GM, Perry CM (2002) Infliximab: an updated review of its use in Crohn’s disease and rheumatoid arthritis. BioDrugs 16:111–148Google Scholar
  2. 2.
    Blumenauer B, Judd M, Wells G, Burls A, Cranney A, Hochberg M et al (2002) Infliximab for the treatment of theumatoid arthritis. Cochrane Database Syst Rev 3:CD003785Google Scholar
  3. 3.
    Kalden JR (2002) Emerging role of anti-tumor necrosis factor therapy in rheumatic diseases. Arthritis Res 4[Suppl 2]:S34–S40Google Scholar
  4. 4.
    Chaudhari U, Romano P, Mulcahy LD, Dooley LT, Baker DG, Gottlieb AB (2001) Efficacy and safety of infliximab monotherapy for plaque-type psorias: a randomised trial. Lancet 357(9271):1842–1847CrossRefPubMedGoogle Scholar
  5. 5.
    Hanauer SB (1999) Review article: safety of infliximab in clinical trials. Aliment Pharmacol Ther 13[Suppl 4]:16–22CrossRefPubMedGoogle Scholar
  6. 6.
    Mohan N, Edwards ET, Cupps TR, Oliverio PJ, Sandberg G, Crayton H et al (2001) Demyelination occurring during anti-tumor necrosis factor alpha therapy for inflammatory arthritides. Arthritis Rheum 44:2862–2869PubMedGoogle Scholar
  7. 7.
    Lee JH, Slifman NR, Gershon SK, Edwards ET, Schwieterman WD, Siegel JN et al (2002) Life-threatening histoplasmosis complicating immunotherapy with tumor necrosis factor alpha antagonists infliximab and etanercept. Arthritis Rheum 46:2565–2570CrossRefPubMedGoogle Scholar
  8. 8.
    Shergy WJ, Isern RA, Cooley DA, Harshbarger JL, Huffstutter JE, Hughes GM et al (2002) Open label study to assess infliximab safety and timing of onset of clinical benefit among patients with theumatoid arthritis. J Rheumatol 29:647–649Google Scholar
  9. 9.
    Szanto E, Linse U (1991) Arthropathy associated with palmoplantar pustulosis. Clin Rheumatol 10:130–135Google Scholar
  10. 10.
    DiCaudo DJ, Connolly SM (2002) Neutrophilic dermatosis (pustular vasculitis) of the dorsal hands. Arch Dermatol 138:361–365Google Scholar
  11. 11.
    Vanbiervliet G, Anty R, Schneider SM, Arab K, Rampal P, Hebuterne X (2002) Traitement d’un syndrome de Sweet et d’un érythème noueux compliquant une maladie de Crohn par anti-TNF-α (infliximab). Gastroenterol Clin Biol 26:295–297Google Scholar
  12. 12.
    Maini RN, Breedveld FC, Kalden JR (1998) Therapeutic efficacy of multiple intravenous infusions of anti-tumour necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum 41:1552–1563CrossRefPubMedGoogle Scholar
  13. 13.
    Kaipiainen-Seppanen O, Leino M (2003) Recurrent uveitis in a patient with juvenile spondyloarthropathy associated with tumour necrosis factor α inhibitors. Ann Rheum Dis 62:88–89CrossRefGoogle Scholar
  14. 14.
    McCain ME, Quinet RJ, Davis WE (2002) Etanercept and infliximab associated with cutaneous vasculitis. Rheumatology 41:116–117Google Scholar
  15. 15.
    Berg L, Lampa J, Rogberg S, van Vollenhoven R, Klareskog L (2001) Increased T cell reactivity to microbial antigens and collagen type II in rheumatoid arthritis after treatment with soluble TNFα receptors. Ann Rheum Dis 60:133–139Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • M. J. F. Starmans-Kool
    • 1
  • H. R. M. Peeters
    • 1
  • H. H. M. L Houben
    • 1
  1. 1.Department of RheumatologyAtrium Medical CentreHeerlenThe Netherlands

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