Dermal lesions associated with anti-tumor necrosis factor α therapy in patients with inflammatory bowel disease (IBD): findings from a tertiary IBD center in Poland.

Abstract

Introduction: There are scarce data on the occurrence of dermal lesions in patients with inflammatory bowel disease (IBD) treated with anti-tumor necrosis factor α (anti-TNF‑α) antibodies. Characteristics of the skin lesions, their clinical course, and impact on treatment are of high importance.

Objectives: The aim of this study was to assess the prevalence, risk factors, and clinical sequelae of dermal lesions in IBD patients treated with anti-TNF‑α antibodies.

Patients and methods: This retrospective, single‑center study evaluated 541 IBD patients treated with anti-TNF‑α drugs and 688 IBD individuals with no history of anti-TNF‑α treatment.

Results: Higher prevalence of dermal lesions was noted in the patients on anti-TNF‑α therapy than in the individuals not receiving such treatment (30.9% vs 16.4%; P <0.001). Risk factors for dermal lesions included higher body mass index (BMI), Crohn disease located in the small intestine, and longer duration of therapy. Some types of dermal lesions were associated with anti-TNF‑α therapy; these included infusion reactions and injection site reactions, cutaneous infection, psorasiform reactions, and lupus‑like symptoms. Overall, 5.9% of the patients on anti-TNF‑α therapy required treatment change or discontinuation due to dermal lesions (alopecia, lupus‑like symptoms, melanoma, and psoriasis).

Conclusions: We observed a higher prevalence of dermal lesions in patients with IBD undergoing anti-TNF‑α therapy than in the treatment-naive group, although development of such lesions rarely necessitated a change in or discontinuation of treatment. Patients with IBD should regularly undergo follow-up dermatologic evaluation, which may improve detection of dermal lesions. Moreover, biologic therapy in IBD patients requires close collaboration with an experienced dermatologist.