Dermal lesions associated with anti-tumor necrosis factor-α therapy in patients with inflammatory bowel disease: findings from an inflammatory bowel disease tertiary center in Poland

Abstract

Introduction: There is little data on the development of dermal lesions in patients with inflammatory bowel disease (IBD) treated with anti - tumor necrosis factor-α (anti-TNF-α), while their characteristics, clinical course, and impact on treatment are of great concern.

Objectives: The aim of this study is 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 compared them with 688 IBD anti-TNF-α-naïve patients.

Results : A significant higher prevalence of dermal lesions was noted during the anti-TNF-α therapy of 30.9% patients versus 16.4% (P <0.001). Risk factors for dermal lesions were higher body mass index (BMI), Crohn’s disease located in the small intestine, and longer duration of therapy. Some types of dermal lesions were associated with anti-TNF-α therapy: infusion reactions and injection site reactions, cutaneous infection, psorasiform reactions, and lupus-like symptoms. Dermal lesions (alopecia, lupus-like symptoms, melanoma, and psoriasis) occurred in 5.9% of patients who discontinued or changed anti-TNF-α therapy.

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