Title:Cutaneous Autoimmune Phenomena of the Anti-TNFa Biosimilars. Casebased Review
Volume: 17
Issue: 2
Author(s): Eleftherios Pelechas, Alexandra Papoudou-Bai, Paraskevi V. Voulgari and Alexandros A. Drosos*
Affiliation:
- Department of Internal Medicine, Rheumatology Clinic, Medical School, University of Ioannina, Ioannina,Greece
Keywords:
RA, TNF inhibitors, autoimmune phenomena, psoriatic skin lesions, SB-4, TNFα.
Abstract: Background: Psoriasis (Pso) is a common chronic inflammatory disease affecting the
skin, both sexes, and all ages. It can be associated with other chronic inflammatory musculoskeletal
disorders and certain drugs, including tumor necrosis factor α (TNFα) antagonists.
Case Presentation: A 64-year-old man with seronegative rheumatoid arthritis (RA) refractory to leflunomide
and prednisone was treated with SB-4 (Benepali), an etanercept biosimilar 50mg/week
subcutaneously. He responded well to the treatment, but a year later, he developed erythematous
skin eruptions affecting mainly in the palms of both hands. Skin biopsy showed a picture compatible
with Pso. SB-4 was discontinued, and the skin lesions disappeared with the addition of topical
steroid therapy. This is the only case of psoriatic skin lesions associated with SB-4 treatment.
Conclusion: Thus, we review and discuss the relevant literature of Pso cases related to SB-4 and
other anti-TNFα biosimilars. Rheumatologists dealing with patients on anti-TNFα biosimilars
should be aware of and recognize these complications.
