Table 4

Drug-related skin eruptions in patients with rheumatoid arthritis (RA) given TNF-α-blocking therapy

Patient no.

Age (yr)

Sex

Drug^a

Route

Type of eruption

Clinical description

Localization

Time to event (mo)

Biopsy

Comedication^b

Therapy

Rechallenge

Permanent withdrawal of anti-TNF-α

Course

1

62

f

A

i.v.

Eczematous

Erythematosquamous plaques and papules

Neck/ axillary/ legs

4.5

Yes

naproxen

Local

positive

No

Recurring

2

71

m

A

i.v.

Exanthematous lichenoid

Maculopapular exanthema

Generalized

0.7

Yes

prednisolone, naproxen, paracetamol

Local

positive

Yes

Recovery

3

77

m

E

s.c.

Exanthematous

Macular exanthema

Generalized

6.8

Yes

prednisolone, naproxen, omeprazole

Local

positive

No

Recurring

4

67

m

E

s.c.

Lichenoid

Macular exanthema, purpura

Generalized

1.5

Yes

diclofenac, omeprazole, triamterene, furosemide, candesartan

Topical, systemic

No

Yes

Recovery

5

69

f

I

i.v.

Eczematous

Erythematous plaque

Right cheek

0.1

Yes

MTX, pantoprazole, atenolol, calcium, hydrochlorothiazide

Topical

positive

No

Recurring

6

88

f

I

i.v.

Eczematous urticarial

Erythematosquamous macula, purpura

Lower arms/legs

3.9

Yes

leflunomide, carbasalate calcium, omeprazole, furosemide, simvastatin, paracetamol

Topical

No

Yes

Recovery

7

68

f

I

i.v.

Eczematous urticarial

Erythematosquamous plaques, urticaria, excoriations, lichenification, purpura

Generalized

10.3

No

AZA, furosemide, oxazepam, enalapril, spironolactone, metoprolol, flixotide, formoterol

Topical, systemic

negative

No

Recovery

8

60

f

I

i.v.

Exanthematous

Stippled exanthema

Generalized

0.5

Yes

naproxen, omeprazole

Topical

No

Yes

Recovery

9

53

f

I

i.v.

Exanthematous

Exanthema

Upper arms/legs

0.2

No

indomethacin

Topical

positive

No

Recurring

10

73

f

I

i.v.

Exanthematous, with purpura

Exanthema, purpura

Lower legs

18.8

No

MTX, folic acid, prednisolone, morphine, loperamide, latanoprost

Topical

No

Yes

Recovery

11

70

f

I

i.v.

Exanthematous urticarial

Exanthema, urticaria

Arms/ trunk

16.6

Yes

leflunomide

None

positive

No

Recurring

12

35

f

I

i.v.

Exanthematous urticarial, with purpura

Macular exanthema, uricaria, purpura

Trunk/ axillary/ groins

1.9

Yes

none

Topical

-

Yes

Recovery

13

58

f

I

i.v.

Lichenoid

Erythema, hyperpigmentation, atrophy

Upper legs

15.5

Yes

leflunomide, meloxicam, metoclopramide, acenocoumarol, digoxin

None

No

Yes

Recovery

14

58

f

L

i.v.

Exanthematous

Papular exanthema

Generalized

0.4

Yes

none

Topical

positive

No

Recurring

15

68

m

L

i.v.

Exanthematous lichenoid

Maculopapular exanthema

Generalized

1.7

Yes

prednisolone, paracetamol

Topical

negative

No

Recovery

Events numbers 5 and 11 occurred in the same patient, as did events numbers 2, 3, and 15. ^aA, adalimumab; Age = age ar event; I, infliximab; E, etanercept; L, lenercept. ^bMTX, methotrexate; AZA, azathioprine. f, female; i.v., intravenous; m, male; s.c., subcutaneous.

Flendrie et al. Arthritis Research & Therapy 2005 7:R666   doi:10.1186/ar1724