Japanese Journal of Ophthalmology

, Volume 57, Issue 1, pp 95–97 | Cite as

Psoriasis triggered by infliximab in a patient with Behçet’s disease

  • Yuko Kawazoe
  • Sunao SugitaEmail author
  • Yukiko Yamada
  • Ai Akino
  • Keiko Miura
  • Manabu Mochizuki
Clinical Investigation



To report a case of psoriasis triggered by anti-tumor necrosis factor-alpha (TNF-α) therapy in a uveitis patient with Behçet’s disease.

Case report

A 34-year-old man with established Behçet’s disease was started on infliximab therapy for recurrent uveitis and showed an excellent response. After 2 years of infliximab treatment, he developed erythematous scaly plaques on both of his palms and heels. No clinical or serological evidence of infection was found, and there was no personal/family history of psoriasis. Histological examination of one lesion showed that it was consistent with psoriasis. Because of the development of hyperkeratotic skin lesions consistent with guttate psoriasis, the infliximab treatment was discontinued. Six months later, the psoriasis had resolved.


Blockade of TNF-α is an effective treatment for psoriasis as well as Behçet’s disease. However, we have to consider new-onset psoriasis as an adverse side effect that can be triggered by anti-TNF-α therapy in Behçet’s disease.


Infliximab Behçet’s disease Uveitis Psoriasis 


  1. 1.
    Shergy WJ, Isern RA, Cooley DA, Harshbarger JL, Huffstutter JE, Hughes GM, et al. Open label study to assess infliximab safety and timing of onset of clinical benefit among patients with rheumatoid arthritis. J Rheumatol. 2002;29:667–77.PubMedGoogle Scholar
  2. 2.
    Hanauer SB, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF, et al. Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet. 2002;359:1541–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Schopf RE, Aust H, Knop J. Treatment of psoriasis with the chimeric monoclonal antibody against tumor necrosis factor alpha, infliximab. J Am Acad Dermatol. 2002;46:886–91.PubMedCrossRefGoogle Scholar
  4. 4.
    Ohno S, Nakamura S, Hori S, Shimakawa M, Kawashima H, Mochizuki M, et al. Efficacy, safety, and pharmacokinetics of multiple administration of infliximab in Behçet disease with refractory uveoretinitis. J Rheumatol. 2004;31:1362–8.PubMedGoogle Scholar
  5. 5.
    Sfikakis PP, Kaklamanis PH, Elezoglou A, Katsilambros N, Theodossiadis PG, Papaefthimiou S, et al. Infliximab for recurrent, sight-threatening ocular inflammation in Adamantiades-Behçet disease. Ann Intern Med. 2004;140:404–6.PubMedGoogle Scholar
  6. 6.
    Yamada Y, Sugita S, Tanaka H, Kamoi K, Kawaguchi T, Mochizuki M. Comparison of infliximab versus cyclosporine during the initial 6-month treatment period in Behçet disease. Br J Opthalmol. 2010;94:284–8.CrossRefGoogle Scholar
  7. 7.
    Keino H, Okada AA, Watanabe T, Taki W. Decreased ocular inflammatory attacks and background retinal and disc vascular leakage in patients with Behcet’s disease on infliximab therapy. Br J Ophthalmol. 2011;95:1245–50.PubMedCrossRefGoogle Scholar
  8. 8.
    Wang Y, Gaudio PA. Infliximab therapy for 2 patients with Vogt–Koyanagi–Harada syndrome. Ocul Immunol Inflamm. 2008;16:167–71.PubMedCrossRefGoogle Scholar
  9. 9.
    Ito T, Sonoda KH, Hijioka K, Fujimoto T, Ishibashi T. Acquired resistance to infliximab against uveitis due to Behçet’s disease after one year of administration. Jpn J Ophthalmol. 2010;54:502–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Sfikakis PP, Iliopoulos A, Elezoglou A, Kittas C, Stratigos A. Psoriasis induced by anti-tumor necrosis factor therapy. Arthr Rheum. 2005;52:2513–8.CrossRefGoogle Scholar
  11. 11.
    Kary S, Worm M, Audring H, Huscher D, Renelt M, Sörensen H, et al. New onset or exacerbation of psoriatic skin lesions in patients with definite rheumatoid arthritis receiving tumour necrosis factor alpha antagonists. Ann Rheum Dis. 2006;65:405–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Matthews C, Rogers S, FitzGerald O. Development of new-onset psoriasis while on anti-TNFalpha treatment. Ann Rheum Dis. 2006;65:1529–30.PubMedCrossRefGoogle Scholar
  13. 13.
    Collamer AN, Battafarano DF. Psoriatic skin lesions induced by tumor necrosis factor antagonist therapy: clinical features and possible immunopathogenesis. Semin Arthr Rheum. 2010;40:233–40.CrossRefGoogle Scholar
  14. 14.
    Laga AC, Vleugels RA, Qureshi AA, Velazquez EF. Histopathologic spectrum of psoriasiform skin reactions associated with tumor necrosis factor-α inhibitor therapy. A study of 16 biopsies. Am J Dermatopathol. 2010;32:568–73.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2012

Authors and Affiliations

  • Yuko Kawazoe
    • 1
  • Sunao Sugita
    • 1
    • 2
    Email author
  • Yukiko Yamada
    • 1
  • Ai Akino
    • 3
  • Keiko Miura
    • 4
  • Manabu Mochizuki
    • 1
  1. 1.Departments of Ophthalmology and Visual ScienceTokyo Medical and Dental University Graduate School of Medicine and Dental SciencesTokyoJapan
  2. 2.Laboratory for Retinal RegenerationRIKEN Center for Developmental BiologyChuo-ku, KobeJapan
  3. 3.Department of Dermatology, Faculty of MedicineTokyo Medical and Dental University Graduate School of Medicine and Dental SciencesTokyoJapan
  4. 4.Division of Surgical Pathology, Faculty of MedicineTokyo Medical and Dental University Graduate School of Medicine and Dental SciencesTokyoJapan

Personalised recommendations