Efficacy of Eppikajutsubutokadaio for Psoriasis Vulgaris with TNFα Inhibitor-associated Paradoxical Reaction : A Case Report and Literature Review
- VernacularTitle:TNFα阻害薬投与中に Paradoxical Reaction を生じた尋常性乾癬に対し，越婢加朮附湯加大黄が有効であった1例
- Author:
Masayuki MORI
1
;
Kazushi UNEDA
1
;
Akira KANEKO
1
;
Takumi KAYO
1
;
Shuichiro AKIBA
1
;
Masao SUZUKI
1
;
Tadamichi MITSUMA
1
;
Eiichi TAHARA
1
Author Information
- Keywords: psoriasis vulgaris; biological agents; TNF α inhibitor; paradoxical reaction; eppikajutsubutokadaio
- From:Kampo Medicine 2025;76(3):194-199
- CountryJapan
- Language:Japanese
- Abstract: Psoriasis vulgaris is a chronic intractable disease characterized by systemic demarcated erythema and rashes with silvery-white scales. Tumor necrosis factor (TNF) α inhibitors, one of the biological agents, are new therapeutic options for psoriasis vulgaris. However, the number of cases of paradoxical reactions has been increasing in psoriasis patients treated with TNF α inhibitors. Here, we show a successful case indicating the efficacy of Kampo formulas for treating an infliximab-associated paradoxical reaction. The patient was an 83-year-old man. He was diagnosed with psoriasis vulgaris at the age of 69. While receiving infliximab injection and topical steroids, he presented and was admitted to our hospital after painful erythema appeared on his trunk and limbs. He was diagnosed with a paradoxical reaction related to infliximab. We identified the patient’s painful edematous erythema and systemic coldness. Therefore, we stopped infliximab and started to administer eppikajutsubutokadaio. His erythema and other symptoms gradually improved, and he was discharged on the 11th day of hospitalization. Eppikajutsubutokadaio has potential efficacy for psoriasis vulgaris with TNF α inhibitor-associated paradoxical reaction.
