Tumor Necrosis Factor Alpha Blocker-Induced Erythrodermic Sarcoidosis in with Juvenile Rheumatoid Arthritis: A Case Report and Review of the Literature.
- Author:
Su Kyung PARK
1
;
Pyung Han HWANG
;
Seok Kweon YUN
;
Han Uk KIM
;
Jin PARK
Author Information
- Publication Type:Case Report
- Keywords: Child; Erythroderma; Etanercept; Sarcoidosis; Tumor necrosis factor-alpha
- MeSH: Arthritis, Juvenile*; Biopsy; Body Surface Area; Child; Coloring Agents; Dermatitis, Exfoliative; Dermis; Etanercept; Female; Granuloma; Histiocytes; Humans; Lymphocytes; Neurologic Examination; Polymerase Chain Reaction; Sarcoidosis*; Skin; Tumor Necrosis Factor-alpha*
- From:Annals of Dermatology 2017;29(1):74-78
- CountryRepublic of Korea
- Language:English
- Abstract: The development of cutaneous sarcoidosis as a paradoxical adverse event of tumor necrosis factor alpha (TNF-α) blockers has been reported in the literature; however, an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy has not yet been reported. Herein, we report the first case of an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy and review previous studies of cutaneous sarcoidosis. A 6-year-old Korean girl who had been suffering from juvenile rheumatoid arthritis presented with generalized erythematous skin eruption involving more than about 90% of her body surface area. After 14 months of etanercept treatment, the new erythematous skin eruption had developed and progressed into generalized erythroderma. Exclusion of suspected co-medication had been performed based on medication history. She had no other systemic symptoms, and ophthalmologic and neurologic examinations were normal. Histopathologic findings of the skin lesion revealed diffuse non-caseating granulomatous infiltrates composed of epithelioid histiocytes with sparse lymphocytes involving the entire dermis. Periodic-acid-Schiff and acid-fast stains were negative, and acid-fast bacilli was not detected by polymerase chain reaction of the skin biopsy. Based on clinicopathologic findings, she was diagnosed with etanercept-induced sarcoidal granuloma. After discontinuation of the suspected agent, the lesions spontaneously disappeared.
