Pyoderma gangrenosum following anti-TNF therapy in chronic recurrent multifocal osteomyelitis: drug reaction or cutaneous manifestation of the disease? A critical review on the topic with an emblematic case report
Articolo
Data di Pubblicazione:
2023
Citazione:
Pyoderma gangrenosum following anti-TNF therapy in chronic recurrent multifocal osteomyelitis: drug reaction or cutaneous manifestation of the disease? A critical review on the topic with an emblematic case report / M. Romagnuolo, C. Moltrasio, C. Iannone, M. Gattinara, S. Cambiaghi, A.V. Marzano. - In: FRONTIERS IN MEDICINE. - ISSN 2296-858X. - 10:(2023), pp. 1197273.1-1197273.11. [10.3389/fmed.2023.1197273]
Abstract:
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease, clinically characterized by chronic and recurrent episodes of osteoarticular inflammation, that generally presents in children and adolescents. From a dermatological point-of-view, CMRO can be associated with skin rashes mainly including psoriasis, palmoplantar pustulosis and acne. Pyoderma gangrenosum (PG) is a rare immune-mediated inflammatory skin disease classified within the spectrum of neutrophilic dermatoses that, in some cases, has been reported as cutaneous manifestation in CMRO patients. This paper presents a 16-year female patient diagnosed with CMRO, who presented PG lesions located on the lower leg, that arose after the administration of the tumour necrosis factor (TNF)-α inhibitor adalimumab. Cases of PG have been reported in patients being treated with certain medications, including TNF-α antagonists, leading to classified them in a setting aptly termed "drug-induced PG." In this paper, we discuss the co-occurrence of PG and CRMO, in the light of recent evidence on the pathogenesis of both diseases and giving ample space to a literature review on drug induced PG. In our case, it is plausible that PG could be considered a cutaneous manifestation of CRMO, although the mechanisms underlying this intriguingly relationship remain to be fully unraveled.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
adalimumab; adverse drug reaction; anti-TNF; chronic recurrent multifocal osteomyelitis; drug-induced PG; pustular lesion; pustular psoriasis; pyoderma gangrenosum
Elenco autori:
M. Romagnuolo, C. Moltrasio, C. Iannone, M. Gattinara, S. Cambiaghi, A.V. Marzano
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