| Peer-Reviewed

Erythema Nodosum During Adalimumab Therapy: An Idiopathic Transient Paradoxical Effect

Received: 16 August 2015     Accepted: 20 August 2015     Published: 29 August 2015
Views:       Downloads:
Abstract

Contrary to their undoubted efficacy on rheumatologic diseases, potential for developing skin lesions with Tumor necrosis alpha blockers (Anti-TNF alpha) is an important question in our minds. Although we know, most of the studies and case reports in the literature show that adalimumab is an effective treatment agent on erythema nodosum, we should keep in mind this lesion as a rare paradoxical side-effect. Here we present a case of idiopathic transient erythema nodosum during adalimumab therapy.

Published in American Journal of Internal Medicine (Volume 3, Issue 5)
DOI 10.11648/j.ajim.20150305.13
Page(s) 210-212
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Anti-TNF Alpha, Adalimumab, Rheumatoid Arthritis, Erythema Nodosum

References
[1] Lipsky PE, van der Heijde DM, St Clair EW, et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis.Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med 2000; 343: 1594-1602.
[2] Moreland LW,Schiff MH, Baumgartner SW, et al. Etanercept therapy in rheumatoid arthritis. A randomised, controlled trial. Ann Intern Med 1999; 130: 478-486.
[3] Weinblatt ME, Keystone EC, Furst DE, et al. Adalimumab, a fully human anti-tumor necrosis factor alpha monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial. Arthritis Rheum 2003; 48: 35-45.
[4] Lovell DJ, Giannini EH, Reiff A, et al. Long-term efficacy and safety of etanercept in children with polyarticular-course juvenile rheumatoid arthritis: results from an ongoing multicenter, open-label, extended-treatment trial. Arthritis Rheum 2003; 48: 218-226.
[5] Brandt J, Khariouzov A, Listing J, et al. Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum 2003; 48: 1667-1675.
[6] Braun J, Brandt J, Listing J, et al. Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet 2002; 359: 1187-1193.
[7] Mease PJ, Goffe BS, Metz J, Vanderstoep A, Finck B, Burge DJ. Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet 2000; 356: 385-390.
[8] Maini R, St Clair EW, Breedveld F, et al. Infliximab (chimeric anti-tumor necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. ATTRACT Study Group. Lancet 1999; 354: 1932-1939.
[9] Keystone EC, Kavanaugh AF, Sharp JT, et al. Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomised, placebo-controlled, 52-week trial. Arthritis Rheum 2004; 50: 1400-1411.
[10] Bleumink GS, ter Borg EJ, Ramselaar CG, Stricker BHC. Etanercept-induced subacute cutaneous lupus erythematosus. Rheumatology 2001; 40: 1317-1319.
[11] Brion PH, Mittal HA, Kalunian KC. Autoimmune skin rashes associated with etanercept for rheumatoid arthritis (letter). Ann Inter Med 1999; 131: 634.
[12] Kent PD, Davis JM, Davis MDP, Matteson EL. Bullous skin lesions following infliximab infusion in a patient with rheumatoid arthritis. Arthritis Rheum 2002; 46: 2257-2258.
[13] Misery L, Perrot JL, Gentil PA, Pallot PB, Cambazard F, Alexandre C. Dermatological complications of etanercept therapy for rheumatoid arthritis. Br J Dermatol 2002; 146: 334-335.
[14] Vergara G, Silvestre JF, Betlloch I, Vela P, Albares MP, Pascual JC. Cutaneous drug eruption to infliximab: Report of 4 cases with an interface dermatitis pattern. Arch Dermatol 2002; 138: 1258-1259.
[15] Wright RC. Atopic dermatitis-like eruption precipitated by infliximab. J Am Acad Dermatol 2003; 49: 160-161.
[16] Flendrie M, Vissers W, Creemers M, Jong E, Kerkhof P, Riel P. Dermatological conditions during TNF-alpha-blocking therapy in patients with rheumatoid arthritis: a prospective study. Arthritis Res Ther 2005; 7: 666-676.
[17] Goodfield MJD, Jones SK, Veale DJ. The connective tissue diseases. Textbook of Dermatology, Vol. 2, 7th edn. Blackwell Science, Oxford, 2004; 56: 138-140.
[18] Scheinfeld N. Adalimumab: a review of side effects. Expert Opin Drug Saf 2005; 4: 637-641.
[19] Scheinfeld N. A comprehensive review and evaluation of the side effects of the tumor necrosis factor alpha blockers etanercept, infliximab and adalimumab. J Dermatolog Treat 2004; 15: 280-294.
[20] Saripalli YV, Gaspari AA. Focus on biologics that affect therapeutic agents in dermatology: J Drugs Dermatol 2005; 4: 233-245.
[21] Beuthien W, Mellinghoff H-U, von Kempis J. Skin reaction to Adalimumab. Arthritis Rheum 2004; 50: 1690-1692.
[22] Delle Sedie A, Bazzichi L, Bpmbardieri S, Riente L. Psoriasis, erythema nodosum, and nummular eczema onset in an ankylosing spondylitis patient treated with infliximab.Scand J Rheumatol 2007; 36(5): 403-404.
[23] Rajakulendran S, Deighton C. Adverse dermatological reactions in rheumatoid arthritis patients treated with etanercept, an anti-TNFalpha drug. Curr Drug Saf 2006; 1(3): 259-264.
[24] Zippi M, Pica R, De Nitto D, Paoluzi P. Biological therapy for dermatological manifestations of inflammatory bowel disease. World J Clin Cases 2013; 1(2): 74-78.
[25] Dalmau-Carolà J. Erythema nodosum, a "red flag" during anti-TNF therapy. Int J Rheum Dis 2013; 16(4): 493-494.
[26] Tanida S, Inoue N, Kobayashi K, et al. Adalimumab for the treatment of Japanese patients with intestinal Behçet's disease. Clin Gastroenterol Hepatol 2015; 13(5): 940-948.
[27] Benítez-Gutiérrez L, Tutor-de Ureta P, Mellor-Pita S, Yebra-Bango M. Refractory chronic erythema nodosum treated with adalimumab. Rev Clin Esp (Barc) 2013; 213(9): 466-467. [Article in Spanish]
[28] Ortego-Centeno N, Callejas-Rubio JL, Sanchez-Cano D, Caballero-Morales T. Refractory chronic erythema nodosum successfully treated with adalimumab. J Eur Acad Dermatol Venereol 2007; 21(3): 408-410.
[29] Quin A, Kane S, Ulitsky O. A case of fistulizing Crohn's disease and erythema nodosum managed with adalimumab.Nat Clin Pract Gastroenterol Hepatol 2008; 5(5): 278-281.
Cite This Article
  • APA Style

    Ilker Ilhanli, Yunus Durmaz, Necip Guder, Kıvanc Cengiz. (2015). Erythema Nodosum During Adalimumab Therapy: An Idiopathic Transient Paradoxical Effect. American Journal of Internal Medicine, 3(5), 210-212. https://doi.org/10.11648/j.ajim.20150305.13

    Copy | Download

    ACS Style

    Ilker Ilhanli; Yunus Durmaz; Necip Guder; Kıvanc Cengiz. Erythema Nodosum During Adalimumab Therapy: An Idiopathic Transient Paradoxical Effect. Am. J. Intern. Med. 2015, 3(5), 210-212. doi: 10.11648/j.ajim.20150305.13

    Copy | Download

    AMA Style

    Ilker Ilhanli, Yunus Durmaz, Necip Guder, Kıvanc Cengiz. Erythema Nodosum During Adalimumab Therapy: An Idiopathic Transient Paradoxical Effect. Am J Intern Med. 2015;3(5):210-212. doi: 10.11648/j.ajim.20150305.13

    Copy | Download

  • @article{10.11648/j.ajim.20150305.13,
      author = {Ilker Ilhanli and Yunus Durmaz and Necip Guder and Kıvanc Cengiz},
      title = {Erythema Nodosum During Adalimumab Therapy: An Idiopathic Transient Paradoxical Effect},
      journal = {American Journal of Internal Medicine},
      volume = {3},
      number = {5},
      pages = {210-212},
      doi = {10.11648/j.ajim.20150305.13},
      url = {https://doi.org/10.11648/j.ajim.20150305.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20150305.13},
      abstract = {Contrary to their undoubted efficacy on rheumatologic diseases, potential for developing skin lesions with Tumor necrosis alpha blockers (Anti-TNF alpha) is an important question in our minds. Although we know, most of the studies and case reports in the literature show that adalimumab is an effective treatment agent on erythema nodosum, we should keep in mind this lesion as a rare paradoxical side-effect. Here we present a case of idiopathic transient erythema nodosum during adalimumab therapy.},
     year = {2015}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Erythema Nodosum During Adalimumab Therapy: An Idiopathic Transient Paradoxical Effect
    AU  - Ilker Ilhanli
    AU  - Yunus Durmaz
    AU  - Necip Guder
    AU  - Kıvanc Cengiz
    Y1  - 2015/08/29
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ajim.20150305.13
    DO  - 10.11648/j.ajim.20150305.13
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 210
    EP  - 212
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20150305.13
    AB  - Contrary to their undoubted efficacy on rheumatologic diseases, potential for developing skin lesions with Tumor necrosis alpha blockers (Anti-TNF alpha) is an important question in our minds. Although we know, most of the studies and case reports in the literature show that adalimumab is an effective treatment agent on erythema nodosum, we should keep in mind this lesion as a rare paradoxical side-effect. Here we present a case of idiopathic transient erythema nodosum during adalimumab therapy.
    VL  - 3
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Department of Physical Medicine and Rehabilitation, School of Medicine, Giresun University, Giresun, Turkey

  • Department of Physical Medicine and Rehabilitation, Division of Rheumatology, School of Medicine, Cumhuriyet University, Sivas, Turkey

  • Physical Medicine and Rehabilitation State Hospital, Giresun, Turkey

  • Sections