Dermatológia pre prax 1/2019

Skin immune-mediated adverse reactions in the biological treatment of chronic inflammatory diseases

Immune-mediated adverse reactions are a new group of diseases developing during anti-TNF alpha treatment, IL-12/23 and IL-17 inhibiton. Their clear etiopathogenesis is not known. Most authors assume that there is a link to possible significant interference of the biologic drug with the immune system, which subsequently induces the above-mentioned responses. However, the individual genetic predisposition, which may be essential in detecting of immune-mediated reactions, must not be overlooked. The reactions include a broad variety of diseases. In this chapter, we will briefly characterise the most common skin immune-mediated reactions like paradoxical psoriasis, hidradenitis suppurativa, alopecia areata, vasculitis, sarcoidosis, lichen and lichenoid reactions, lupus like syndrome, pyoderma gangrenosum and morphea.

Keywords: immune-mediated reaction, adverse reaction, anti-TNF alpha, psoriasis