Hidradenitis suppurativa (HS): An unrecognized paradoxical effect of biologic agents (BA) used in chronic inflammatory diseases.

Autor: Faivre C; Dermatology Department, Hôpital Edouard Herriot, Université Claude Bernard Lyon I, Lyon, France. Electronic address: coline.faivre@gmail.com., Villani AP; Dermatology Department, Hôpital Edouard Herriot, Université Claude Bernard Lyon I, Lyon, France., Aubin F; Dermatology Department, Hôpital Saint-Jacques, Université de Franche-Comté, Besançon, France., Lipsker D; Dermatology Department, Centre Hospitalo-Universitaire (CHU) de Strasbourg, Université de Strasbourg, Strasbourg, France., Bottaro M; Rheumatology Department, Center Hospitalier de Valence, Valence, France., Cohen JD; Rheumatology Department, CHU Lapeyronie, Montpellier, France., Durupt F; Dermatology Department, Center Hospitalier de Valence, Valence, France., Jeudy G; Dermatology Department, CHU de Dijon, Dijon, France., Sbidian E; Dermatology Department, CHU Henri-Mondor, Créteil, France., Toussirot E; Clinical Investigation Center for Biotherapy, Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d'Investigation Clinique (CIC) 1431 and Rheumatology, Université de Franche-Comté, Besançon, France., Badot V; Rheumatology Department, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Barbarot S; Dermatology Department, CHU Hôtel Dieu, Nantes, France., Debarbieux S; Dermatology Department, Center Hospitalier Lyon-Sud, Lyon, France., Delaporte E; Dermatology Department, Hôpital Claude-Huriez, Université Lille II, Lille, France., Goegebeur G; Hepatogastroenterology Department, Center Hospitalier Loire Vendée Océan, Challans, France., Morel J; Rheumatology Department, CHU Lapeyronie, Université de Montpellier, Montpellier, France., Nassif A; Infectious Diseases Center Necker-Pasteur, Pasteur Institute, Assistance Publique-Hôpitaux de Paris, Paris, France., Duru G; Dermatology Department, Hôpital Edouard Herriot, Université Claude Bernard Lyon I, Lyon, France., Jullien D; Dermatology Department, Hôpital Edouard Herriot, Université Claude Bernard Lyon I, Lyon, France.
Jazyk: angličtina
Zdroj: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2016 Jun; Vol. 74 (6), pp. 1153-9. Date of Electronic Publication: 2016 Mar 08.
DOI: 10.1016/j.jaad.2016.01.018
Abstrakt: Background: Paradoxical hidradenitis suppurativa (HS) induced by biologic agents (BA) is scarcely reported.
Objective: We sought to describe the clinical characteristics and outcome of patients developing paradoxical HS under BA.
Methods: This was a multicenter nationwide retrospective study asking physicians to report all cases of HS, confirmed by a dermatologist, occurring during treatment of an inflammatory disease by a BA.
Results: We included 25 patients (15 inflammatory rheumatism, 9 Crohn's disease, 1 psoriasis) treated by 5 BA (adalimumab = 12, infliximab = 6, etanercept = 4, rituximab = 2, tocilizumab = 1). Median duration of BA exposure before HS onset was 12 (range 1-120) months. Patients were mostly Hurley stage I (n = 13) or II (n = 11). Simultaneously to HS or within 1 year, 11 patients developed additional inflammatory diseases, including paradoxical reactions (psoriasis = 9, Crohn's disease = 3, alopecia areata = 1, erythema elevatum diutinum = 1). Complete improvement of HS was more frequently obtained after BA discontinuation or switch (n = 6/10, 60%) rather than maintenance (n = 1/14, 7%). Reintroducing the same BA resulted in HS relapse in 3 of 3 patients.
Limitations: Retrospective nature and lack of complete follow-up for some patients are limitations.
Conclusion: HS is a rare paradoxical adverse effect of BA, but fortuitous association cannot be excluded in some cases. We observed a trend toward better outcome when the BA was discontinued or switched.
(Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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