Cutaneous immune-related phenomena in patients with inflammatory arthritides treated with biological therapies: Clinical and pathophysiological considerations

• Published in: Seminars in arthritis and rheumatism Vol. 63; p. 152272
• Main Authors: Venetsanopoulou, Aliki I., Mavridou, Konstantina, Voulgari, Paraskevi V., Drosos, Alexandros A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2023
• Subjects: Biologic drugs; cutaneous adverse events; Skin lesions; Tumor necrosis factor inhibitors; cutaneous adverse events; Tumor necrosis factor inhibitors; Biologic drugs; Skin lesions
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2023.152272

•The use of biological treatments may induce immune-related cutaneous adverse events.•Among the immune-related cutaneous adverse events observed with biological agents, psoriasis is the most often reported.•Early recognition of immune-related cutaneous adverse events is essential for physicians to manage their patients adequately. In recent years, identifying the pathophysiologic mechanisms underlying autoimmune arthritides and systematic diseases has led to the use of biological drugs. The primary targets of those biological therapies are cytokines, B cells, and co-stimulation molecules. So far, these targeted therapies have shown good clinical improvement and an acceptable toxicity profile. However, by blocking components of an intact immune system, autoimmune phenomena and paradoxical inflammation have emerged, and among them many cutaneous immune-related adverse events (irAEs). In this article, we review the current state of knowledge on the clinical features and mechanisms of specific cutaneous irAEs observed during treatment with biological therapies. Among those, psoriatic skin lesions are the most commonly observed. Herein, we also report new cases of cutaneous irAEs recently seen in our clinic to help physicians treating inflammatory arthritides recognize cutaneous irAEs early and better manage patients receiving biologic therapies. [Display omitted]