Korean J Gastroenterol.  2010 Nov;56(5):324-328. 10.4166/kjg.2010.56.5.324.

A Case of Psoriasis Induced by Infliximab Treatment for Crohn's Disease

• Jwa YJ
• Kim NH
• Park HJ
• Park JS
• Bae WK
• Kim KA
• Lee JS
• Moon YS

• KMID: 1718375
• DOI: http://doi.org/10.4166/kjg.2010.56.5.324

Abstract

Infliximab, the monoclonal antibody to tumor necrosis factor, is indicated for refractory luminal and fistulizing Crohn's disease and rheumatoid arthritis. Infliximab treatment has adverse events including infusion reactions, opportunistic infections, and the potential for the event such as reactivation of latent tuberculosis. Cutaneous adverse reactions of TNF-alpha agents include skin rash, urticaria, pruritus, lupus-like eruption, and injection site reactions. Most of all, psoriasis or psoriasiform dermatitis induced by infliximab treatment for Crohn's disease is rarely reported in Korea. We report a case of psoriasis induced by infliximab treatment for Crohn's disease with a review of world literature.

Keyword

Crohn's disease; Infliximab; Psoriasis

MeSH Terms

Anti-Inflammatory Agents/*adverse effects/therapeutic use
Antibodies, Monoclonal/*adverse effects/therapeutic use
Colonoscopy
Crohn Disease/diagnosis/*drug therapy
Female
Humans
Psoriasis/*chemically induced/pathology/therapy
Ultraviolet Rays
Young Adult

Figure

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  Fig. 1. Initial colonoscopic findings. (A) Perianal fistula was seen. (B, C) Longitudinal ulcers with cobble stone appearance were observed at the terminal ileum. (D) Another apthous ulcers were noted at the descending colon.

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  Fig. 2. Photographs of the skin lesion. (A) Psoriasis with reddened skin and pustules was developed on the back. (B) After treatment, the skin lesion was completely healed, with no signs of discoloration or scarring.

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  Fig. 3. Microscopic finding of the skin lesion. Hyperkeratosis, dermal papilla elongation, and perivascular lymphocytic infiltration were seen (H&E stain, ×100).

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  Fig. 4. Post-infliximab treatment colonoscopic findings. (A) The closure of perianal fistula opening was noted. (B, C) Longitudinal ulcer scars with pseudopolyps were noted at the terminal ileum. (D) Ulcer scars with pseudopolyps were seen at the descending colon.

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