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The Use of TNFα Inhibitors in Treating Pediatric Skin Disorders

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Abstract

Tumor necrosis factor alpha (TNF) inhibitors have had a significant impact in medicine since the approval of the first drug of its class by the US FDA in 1998. New clinical data and indications have emerged for TNF inhibitors in recent years. Currently, four TNF inhibitors have been approved by the US FDA for dermatology, two of which include US FDA-approved pediatric use. In particular, growing evidence supports the use of etanercept and adalimumab as attractive therapies for pediatric psoriasis. Data for use of etanercept in treating toxic epidermal necrolysis and either etanercept or infliximab for Kawasaki disease is expanding. In addition, there have been clinical reports on the use of TNF inhibitors to treat a variety of other pediatric dermatologic conditions. To help clinicians keep pace with the new data provided by many pediatric dermatology studies involving TNF inhibitors, this review provides an overview of the use of TNF inhibitors in the treatment of pediatric plaque psoriasis, hidradenitis suppurativa, atopic dermatitis, pyoderma gangrenosum, toxic epidermal necrolysis, and Kawasaki disease. For TNF inhibitors with little data in the pediatric population, data on adult use is discussed. Furthermore, the review summarizes available clinical data on efficacy, safety, and tolerability of agents currently available.

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References

  1. Kolb WP, Granger GA. Lymphocyte in vitro cytotoxicity: characterization of human lymphotoxin. Proc Natl Acad Sci USA. 1968;61(4):1250–5.

    Article  CAS  PubMed  Google Scholar 

  2. Carswell EA, Old LJ, Kassel RL, Green S, Fiore N, Williamson B. An endotoxin-induced serum factor that causes necrosis of tumors. Proc Natl Acad Sci USA. 1975;72(9):3666–700.

    Article  CAS  PubMed  Google Scholar 

  3. Pisetsky DS. Tumor necrosis factor: is it time to change the name? Arthritis Res Ther. 2014;16(2):108.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Monaco C, Nanchahal J, Taylor P, Feldmann M. Anti-TNF therapy: past, present and future. Int Immunol. 2015;27(1):55–62.

    Article  CAS  PubMed  Google Scholar 

  5. Elliott MJ, Maini RN, Feldmann M, Long-Fox A, Charles P, Katsikis P, et al. Treatment of rheumatoid arthritis with chimeric monoclonal antibodies to tumor necrosis factor alpha. Arthritis Rheum. 1993;36(12):1681–90.

    Article  CAS  PubMed  Google Scholar 

  6. Beylot C, Puissant A, Bioulac P, Saurat JH, Pringuet R, Doutre MS. Particular clinical features of psoriasis in infants and chidren. Acta Derm Venereol Suppl (Stockh). 1979;87:95–7.

    CAS  Google Scholar 

  7. Lewkowicz D, Gottlieb AB. Pediatric psoriasis and psoriatic arthritis. Dermatol Ther. 2004;17(5):364–75.

    Article  PubMed  Google Scholar 

  8. Paller AS, Siegfried EC, Langley RG, Gottlieb AB, Pariser D, Landells I, et al. Etanercept treatment for children and adolescents with plaque psoriasis. N Engl J Med. 2008;358(3):241–51.

    Article  CAS  PubMed  Google Scholar 

  9. Paller AS, Siegfried EC, Pariser DM, Rice KC, Trivedi M, Iles J, et al. Long-term safety and efficacy of etanercept in children and adolescents with plaque psoriasis. J Am Acad Dermatol. 2016;74(2):280–287.e3.

    Article  CAS  PubMed  Google Scholar 

  10. Langley RG, Kasichayanula S, Trivedi M, Aras GA, Kaliyaperumal A, Yuraszeck T, et al. Pharmacokinetics, immunogenicity, and efficacy of etanercept in pediatric patients with moderate to severe plaque psoriasis. J Clin Pharmacol. 2018;58(3):340–6.

    Article  CAS  PubMed  Google Scholar 

  11. Bronckers IMGJ, Seyger MMB, West DP, Lara-Corrales I, Tollefson M, Tom WL, et al. Safety of systemic agents for the treatment of pediatric psoriasis. JAMA Dermatol. 2017;153(11):1147–57.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lernia VD, Guarneri C, Stingeni L, Gisondi P, Bonamonte D, Pinton PGC, et al. Effectiveness of etanercept in children with plaque psoriasis in real practice: a one-year multicenter retrospective study. J Dermatol Treat. 2018;29(3):217–9.

    Article  CAS  Google Scholar 

  13. Papp K, Thaçi D, Marcoux D, Weibel L, Philipp S, Ghislain P-D, et al. Efficacy and safety of adalimumab every other week versus methotrexate once weekly in children and adolescents with severe chronic plaque psoriasis: a randomised, double-blind, phase 3 trial. Lancet. 2017;390(10089):40–9.

    Article  CAS  PubMed  Google Scholar 

  14. Tsang V, Dvorakova V, Enright F, Murphy M, Gleeson C. Successful use of infliximab as first line treatment for severe childhood generalized pustular psoriasis. J Eur Acad Dermatol Venereol JEADV. 2016;30(11):e117–e11919.

    CAS  PubMed  Google Scholar 

  15. Lebwohl M, Blauvelt A, Paul C, Sofen H, Węgłowska J, Piguet V, et al. Certolizumab pegol for the treatment of chronic plaque psoriasis: results through 48 weeks of a phase 3, multicenter, randomized, double-blind, etanercept- and placebo-controlled study (CIMPACT). J Am Acad Dermatol. 2018;79(2):266–276.e5.

    Article  CAS  PubMed  Google Scholar 

  16. Lee W-K, Kim G-W, Cho H-H, Kim W-J, Mun J-H, Song M, et al. Erythrodermic psoriasis treated with golimumab: a case report. Ann Dermatol. 2015;27(4):446–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Eickstaedt JB, Killpack L, Tung J, Davis D, Hand JL, Tollefson MM. Psoriasis and psoriasiform eruptions in pediatric patients with inflammatory bowel disease treated with anti-tumor necrosis factor alpha agents. Pediatr Dermatol. 2017;34(3):253–60.

    Article  PubMed  Google Scholar 

  18. de Vasconcellos JB, Pereira D do N, Vargas TJ de S, Levy RA, Pinheiro G da RC, Cursi ÍB (2016) Paradoxical psoriasis after the use of anti-TNF in a patient with rheumatoid arthritis. An Bras Dermatol 91(5 Suppl 1):137–9.

  19. Jemec GBE. Hidradenitis Suppurativa. N Engl J Med. 2012;366(2):158–64.

    Article  CAS  PubMed  Google Scholar 

  20. Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol. 2009;60(4):539–61.

    Article  PubMed  Google Scholar 

  21. van der Zee HH, Laman JD, Boer J, Prens EP. Hidradenitis suppurativa: viewpoint on clinical phenotyping, pathogenesis and novel treatments. Exp Dermatol. 2012;21(10):735–9.

    Article  PubMed  CAS  Google Scholar 

  22. Cosmatos I, Matcho A, Weinstein R, Montgomery MO, Stang P. Analysis of patient claims data to determine the prevalence of hidradenitis suppurativa in the United States. J Am Acad Dermatol. 2013;68(3):412–9.

    Article  PubMed  Google Scholar 

  23. Revuz JE, Canoui-Poitrine F, Wolkenstein P, Viallette C, Gabison G, Pouget F, et al. Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. J Am Acad Dermatol. 2008;59(4):596–601.

    Article  PubMed  Google Scholar 

  24. Matusiak Ł, Bieniek A, Szepietowski JC. Hidradenitis suppurativa markedly decreases quality of life and professional activity. J Am Acad Dermatol. 2010;62(4):706–708.e1.

    Article  PubMed  Google Scholar 

  25. Matusiak Ł, Bieniek A, Szepietowski J. Psychophysical aspects of Hidradenitis Suppurativa. Acta Derm Venereol. 2010;90(3):264–8.

    Article  PubMed  Google Scholar 

  26. Sabat R, Chanwangpong A, Schneider-Burrus S, Metternich D, Kokolakis G, Kurek A, et al. Increased prevalence of metabolic syndrome in Patients with Acne Inversa. Bruggemann H, editor. PLoS One. 2012 7(2):e31810

  27. Garg A, Kirby JS, Lavian J, Lin G, Strunk A. Sex- and age-adjusted population analysis of prevalence estimates for Hidradenitis Suppurativa in the United States. JAMA Dermatol. 2017;153(8):760–4.

    Article  PubMed  PubMed Central  Google Scholar 

  28. van der Zee HH, de Ruiter L, van den Broecke DG, Dik WA, Laman JD, Prens EP. Elevated levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TNF-α and IL-1β. Br J Dermatol. 2011;164(6):1292–8.

    Article  PubMed  CAS  Google Scholar 

  29. Kimball AB, Okun MM, Williams DA, Gottlieb AB, Papp KA, Zouboulis CC, et al. Two Phase 3 Trials of Adalimumab for Hidradenitis Suppurativa. N Engl J Med. 2016;375(5):422–34.

    Article  CAS  PubMed  Google Scholar 

  30. Zouboulis C, Okun MM, Gniadecki R, Foley PA, Lynde C, Weisman J, Williams DA. Adalimumab efficacy in hidradenitis suppurativa patients is sustained at least three years with weekly dosing: results from a phase 3 open-label extension study (PIONEER). J Am Acad Dermatol. 2017;76(6):AB33.

    Google Scholar 

  31. Zouboulis CC, Okun MM, Prens EP, Gniadecki R, Foley PA, Lynde C, et al. Long-term adalimumab efficacy in patients with moderate-to-severe hidradenitis suppurativa/acne inversa: 3-year results of a phase 3 open-label extension study. J Am Acad Dermatol. 2019;80(1):60–69.e2.

    Article  CAS  PubMed  Google Scholar 

  32. European Public Assessment Report. Humira [Internet]. European Medicines Agency. 2018 [cited 2019 Jul 22]. https://www.ema.europa.eu/en/medicines/human/EPAR/humira

  33. Blanco R, Martínez-Taboada VM, Villa I, González-Vela MC, Fernández-Llaca H, Agudo M, et al. Long-term successful adalimumab therapy in severe Hidradenitis Suppurativa. Arch Dermatol. 2009;145(5):580–4.

    Article  PubMed  Google Scholar 

  34. Cusack C, Buckley C. Etanercept: effective in the management of hidradenitis suppurativa. Br J Dermatol. 2006;154(4):726–9.

    CAS  PubMed  Google Scholar 

  35. Grant A, Gonzalez T, Montgomery MO, Cardenas V, Kerdel FA. Infliximab therapy for patients with moderate to severe hidradenitis suppurativa: a randomized, double-blind, placebo-controlled crossover trial. J Am Acad Dermatol. 2010;62(2):205–17.

    Article  CAS  PubMed  Google Scholar 

  36. Shaw TE, Currie GP, Koudelka CW, Simpson EL. Eczema prevalence in the United States: data from the 2003 National Survey of Children’s Health. J Invest Dermatol. 2011;131(1):67–73.

    Article  CAS  PubMed  Google Scholar 

  37. Rullan P, Murase J. Two cases of chronic atopic dermatitis treated with soluble tumor necrosis factor receptor therapy. J Drugs Dermatol JDD. 2009;8(9):873–6.

    PubMed  Google Scholar 

  38. Buka RL, Resh B, Roberts B, Cunningham BB, Friedlander S. Etanercept is minimally effective in 2 children with atopic dermatitis. J Am Acad Dermatol. 2005;53(2):358–9.

    Article  PubMed  Google Scholar 

  39. Lebas D, Staumont-Sallé D, Solau-Gervais E, Flipo R-M, Delaporte E. Cutaneous manifestations during treatment with TNF-alpha blockers: 11 cases. Ann Dermatol Venereol. 2007;134(4 Pt 1):337–42.

    Article  CAS  PubMed  Google Scholar 

  40. Mangge H, Gindl S, Kenzian H, Schauenstein K. Atopic dermatitis as a side effect of anti-tumor necrosis factor-alpha therapy. J Rheumatol. 2003;30(11):2506–7.

    PubMed  Google Scholar 

  41. Ruiz-Villaverde R, Galán-Gutierrez M. Exacerbation of atopic dermatitis in a patient treated with infliximab. Actas Dermosifiliogr. 2012;103(8):743–6.

    Article  CAS  PubMed  Google Scholar 

  42. Shirley M. Dupilumab: first global approval. Drugs. 2017;77(10):1115–21.

    Article  CAS  PubMed  Google Scholar 

  43. Treister AD, Lio PA. Long-term off-label dupilumab in pediatric atopic dermatitis: a case series. Pediatr Dermatol. 2019;36(1):85–8.

    Article  PubMed  Google Scholar 

  44. Powell FC, Perry HO. Pyoderma gangrenosum in childhood. Arch Dermatol. 1984;120(6):757–61.

    Article  CAS  PubMed  Google Scholar 

  45. Batres LA, Mamula P, Baldassano RN. Resolution of severe peristomal pyoderma gangrenosum with infliximab in a child with Crohn disease. J Pediatr Gastroenterol Nutr. 2002 34(5):558–60.

    Article  PubMed  Google Scholar 

  46. Kugathasan S, Miranda A, Nocton J, Drolet BA, Raasch C, Binion DG. Dermatologic manifestations of crohn disease in children: response to infliximab. J Pediatr Gastroenterol Nutr. 2003;37(2):150.

    Article  CAS  PubMed  Google Scholar 

  47. Brooklyn TN, Dunnill MGS, Shetty A, Bowden JJ, Williams JDL, Griffiths CEM, et al. Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut. 2006;55(4):505–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Sheldon DG, Sawchuk LL, Kozarek RA, Thirlby RC. Twenty cases of peristomal Pyoderma Gangrenosum. Arch Surg. 2000;135(5):564.

    Article  CAS  PubMed  Google Scholar 

  49. Tan MH, Gordon M, Lebwohl O, George J, Lebwohl MG. Improvement of Pyoderma gangrenosum and psoriasis associated with Crohn disease with anti-tumor necrosis factor alpha monoclonal antibody. Arch Dermatol. 2001 137(7):930–3.

    CAS  PubMed  Google Scholar 

  50. Ljung T, Staun M, Grove O, Fausa O, Vatn MH, Hellström PM. Pyoderma gangrenosum associated with crohn disease: effect of TNF-alpha blockade with infliximab. Scand J Gastroenterol. 2002 37(9):1108–10.

    Article  CAS  PubMed  Google Scholar 

  51. Triantafillidis JK, Cheracakis P, Sklavaina M, Apostolopoulou K. Favorable response to infliximab treatment in a patient with active Crohn disease and pyoderma gangrenosum. Scand J Gastroenterol. 2002 37(7):863–5.

    Article  CAS  PubMed  Google Scholar 

  52. Arnott IDR, Mcdonald D, Williams A, Ghosh S. Clinical use of Infliximab in Crohn’s disease: the Edinburgh experience.

  53. Grange F, Djilali-Bouzina F, Weiss AM, Polette A, Guillaume JC. Corticosteroid-resistant pyoderma gangrenosum associated with Crohn’s disease: rapid cure with infliximab. Dermatol Basel Switz. 2002;205(3):278–80.

    Article  CAS  Google Scholar 

  54. Kechichian E, Haber R, Mourad N, El Khoury R, Jabbour S, Tomb R. Pediatric pyoderma gangrenosum: a systematic review and update. Int J Dermatol. 2017;56(5):486–95.

    Article  PubMed  Google Scholar 

  55. Jacob SE, Weisman RS, Kerdel FA. Pyoderma gangrenosum—rebel without a cure? Int J Dermatol. 2008;47(2):192–4.

    Article  CAS  PubMed  Google Scholar 

  56. Pomerantz RG, Husni ME, Mody E, Qureshi AA. Adalimumab for treatment of pyoderma gangrenosum. Br J Dermatol. 2007;157(6):1274–5.

    Article  CAS  PubMed  Google Scholar 

  57. Kerns MJoJ, Graves JE, Smith DI, Heffernan MP, Off-label uses of biologic agents in dermatology: a 2006 update. Semin Cutan Med Surg. 2006;25(4):226–40.

    Article  CAS  PubMed  Google Scholar 

  58. Roy DB, Conte ET, Cohen DJ. The treatment of pyoderma gangrenosum using etanercept. J Am Acad Dermatol. 2006 54(3):S128–S134134.

    Article  PubMed  Google Scholar 

  59. Pyoderma gangrenosum treated with anti‐TNF alpha therapy (etanercept) - Pastor - 2006 - Clinical and Experimental Dermatology - Wiley Online Library [Internet]. [cited 2020 Jan 11]. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2230.2005.01972.x

  60. Goldenberg G, Jorizzo JL. Use of etanercept in treatment of pyoderma gangrenosum in a patient with autoimmune hepatitis. J Dermatol Treat. 2005;16(5–6):347–9.

    Article  CAS  Google Scholar 

  61. Charles CA, Leon A, Banta MR, Kirsner RS. Etanercept for the treatment of refractory pyoderma gangrenosum: a brief series. Int J Dermatol. 2007;46(10):1095–9.

    Article  PubMed  Google Scholar 

  62. Hsu DY, Brieva J, Silverberg NB, Paller AS, Silverberg JI. Pediatric Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States. J Am Acad Dermatol. 2017;76(5):811–817.e4.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Zhang S, Tang S, Li S, Pan Y, Ding Y. Biologic TNF-alpha inhibitors in the treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis: a systemic review. J Dermatol Treat. 2020 31(1):66–73.

    Article  CAS  Google Scholar 

  64. Wang C-W, Yang L-Y, Chen C-B, Ho H-C, Hung S-I, Yang C-H, et al. Randomized, controlled trial of TNF-α antagonist in CTL-mediated severe cutaneous adverse reactions. J Clin Invest. 2018;128(3):985–96.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Wooldridge KF, Boler PL, Lee BD. Tumor necrosis factor α inhibitors in the treatment of toxic epidermal necrolysis. Cutis. 2018;101(1):E15–E21.

    Google Scholar 

  66. Scott-Lang V, Tidman M, McKay D. Toxic epidermal necrolysis in a child successfully treated with infliximab. Pediatr Dermatol. 2014;31(4):532–4.

    Article  PubMed  Google Scholar 

  67. Zarate-Correa LC, Carrillo-Gomez DC, Ramirez-Escobar AF, Serrano-Reyes C. Toxic epidermal necrolysis successfully treated with infliximab. J Investig Allergol Clin Immunol. 2013;23(1):61–3.

    CAS  PubMed  Google Scholar 

  68. Wojtkiewicz A, Wysocki M, Fortuna J, Chrupek M, Matczuk M, Koltan A, Wojtkiewicz A, Wysocki M, Fortuna J, et al. Beneficial and rapid effect of infliximab on the course of toxic epidermal necrolysis. Acta Derm Venereol. 2008;88(4):420–1.

    PubMed  Google Scholar 

  69. Chafranska L, Saunte DM, Behrendt N, Nygaard U, Christensen RJ, Sand C, et al. Pediatric toxic epidermal necrolysis treated successfully with infliximab. Pediatr Dermatol. 2019;36(3):342–5.

    Article  PubMed  Google Scholar 

  70. Gavigan GM, Kanigsberg ND, Ramien ML. Pediatric Stevens-johnson syndrome/toxic epidermal necrolysis halted by etanercept. J Cutan Med Surg. 2018;22(5):514–5.

    Article  PubMed  Google Scholar 

  71. Paquet P, Jennes S, Rousseau AF, Libon F, Delvenne P, Piérard GE. Effect of N-acetylcysteine combined with infliximab on toxic epidermal necrolysis. A proof-of-concept study. Burns J Int Soc Burn Inj. 2014;40(8):1707–12.

    Article  Google Scholar 

  72. Burns JC, Glodé MP. Kawasaki syndrome. Lancet. 2004 364(9433):533–44.

    Article  PubMed  Google Scholar 

  73. Yamaji N, da Silva LK, Shoda T, Ishitsuka K, Kobayashi T, Ota E, et al. TNF-α blockers for the treatment of Kawasaki disease in children. Cochrane Database Syst Rev. 2019;8:012448.

    Google Scholar 

  74. Nelson AA, Pearce DJ, Fleischer AB, Balkrishnan R, Feldman SR. Cost-effectiveness of biologic treatments for psoriasis based on subjective and objective efficacy measures assessed over a 12-week treatment period. J Am Acad Dermatol. 2008 58(1):125–35.

    Article  PubMed  Google Scholar 

  75. Gu T, Shah N, Deshpande G, Tang DH, Eisenberg DF. Comparing biologic cost per treated patient across indications among adult US Managed care patients: a retrospective cohort study. Drugs Real World Outcomes. 2016 3(4):369–81.

    Article  PubMed  PubMed Central  Google Scholar 

  76. San-Juan-Rodriguez A, Prokopovich MV, Shrank WH, Good CB, Hernandez I. Assessment of price changes of existing tumor necrosis factor inhibitors after the market entry of competitors. JAMA Intern Med. 2019;179(5):713–6.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Duarte A, Mebrahtu T, Goncalves PS, Harden M, Murphy R, Palmer S, et al. Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people: systematic review and economic evaluation. Health Technol Assess Winch Engl. 2017;21(64):1–244.

    Article  Google Scholar 

  78. Mazur M, Olek-Hrab K, Karczewski J, Teresiak-Mikołajczak E, Adamski Z. Biosimilars in dermatology. Adv Dermatol Allergol Dermatol Alergol. 2015;32(5):384–7.

    Article  Google Scholar 

  79. Carrascosa J-M, Jacobs I, Petersel D, Strohal R. Biosimilar Drugs for psoriasis: principles, present, and near future. Dermatol Ther. 2018;8(2):173–94.

    Article  Google Scholar 

  80. Barker J, Girolomoni G, Egeberg A, Goncalves J, Pieper B, Kang T. Anti-TNF biosimilars in psoriasis: from scientific evidence to real-world experience. J Dermatol Treat. 2019;16:1–7.

    Article  CAS  Google Scholar 

  81. Puig L, López-Ferrer A. Biosimilars for the treatment of psoriasis. Expert Opin Biol Ther. 2019;19(10):993–1000.

    Article  PubMed  Google Scholar 

  82. Portman MA, Dahdah NS, Slee A, Olson AK, Choueiter NF, Soriano BD, et al. Etanercept with IVIg for acute Kawasaki disease: a randomized controlled trial. Pediatrics. 2019;143(6):e20183675. https://doi.org/10.1542/peds.2018-3675.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Burns JC, Best BM, Mejias A, Mahony L, Fixler DE, Jafri HS, et al. Infliximab treatment of intravenous immunoglobulin-resistant Kawasaki disease. J Pediatr. 2008;153(6):833–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, UTHealth McGovern Medical School at Houston, Houston, TX, USA

    Quoc-Bao D. Nguyen, Caroline T. Starling & Adelaide A. Hebert

  2. Department of Dermatology and Pediatrics, UTHealth McGovern Medical School at Houston, 6655 Travis St., Suite 980, Houston, TX, 77030, USA

    Adelaide A. Hebert

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Authors Quoc-Bao D. Nguyen, MD, Caroline T. Starling, BS, and Adelaide Hebert, MD contributed to this original review article and  QB Nguyen and CT Starling report no conflicts of interest. Dr. Hebert's conflicts of interest: research funds paid to the UTHealth McGovern Medical School, Houston: Amgen, Sienna, Symbio, GSK, Mayne, Promius Pharma, Ortho Dermatologics, Galderma, Leo. Dr. Hebert honoraria: Ortho Dermatologics, Amgen, Promius, Galderma, Leo; DSMB: GSK, Ortho Dermatologics.  

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Nguyen, QB.D., Starling, C.T. & Hebert, A.A. The Use of TNFα Inhibitors in Treating Pediatric Skin Disorders. Pediatr Drugs 22, 311–319 (2020). https://doi.org/10.1007/s40272-020-00394-3

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