Biological therapy for dermatological manifestations of inflammatory bowel disease  

作　　者：Maddalena Zippi Roberta Pica Daniela De Nitto Paolo Paoluzi 

机构地区：[1]Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital [2]Department of Internal Medicine and Medical Specialties, La Sapienza University

出　　处：《World Journal of Clinical Cases》2013年第2期74-78,共5页世界临床病例杂志

摘　　要：Ulcerative colitis and Crohn's disease are the two forms of inflammatory bowel disease(IBD). The advent of biological drugs has significantly changed the management of these conditions. Skin manifestations are not uncommon in IBD. Among the reactive lesions(immunemediated extraintestinal manifestations), erythema nodosum(EN) and pyoderma gangrenosum(PG) are the two major cutaneous ills associated with IBD, while psoriasis is the dermatological comorbidity disease observed more often. In particular, in the last few years, anti-tumor necrosis factor(TNF)-α agents have been successfully used to treat psoriasis, especially these kinds of lesions that may occur during the treatment with biological therapies. The entity of the paradoxical manifestations has been relatively under reported as most lesions are limited and a causal relationship with the treatment is often poorly understood. The reason for this apparent side-effect of the therapy still remains unclear. Although side effects may occur, their clinical benefits are undoubted. This article reviews the therapeutic effects of the two most widely used anti-TNF-α molecules, infliximab(a fusion protein dimer of the human TNF-α receptor) and adalimumab(a fully human monoclonal antibody to TNF-α), for the treatment of the major cutaneous manifestations associated with IBD(EN, PG and psoriasis).Ulcerative colitis and Crohn's disease are the two forms of inflammatory bowel disease(IBD). The advent of biological drugs has significantly changed the management of these conditions. Skin manifestations are not uncommon in IBD. Among the reactive lesions(immunemediated extraintestinal manifestations), erythema nodosum(EN) and pyoderma gangrenosum(PG) are the two major cutaneous ills associated with IBD, while psoriasis is the dermatological comorbidity disease observed more often. In particular, in the last few years, anti-tumor necrosis factor(TNF)-α agents have been successfully used to treat psoriasis, especially these kinds of lesions that may occur during the treatment with biological therapies. The entity of the paradoxical manifestations has been relatively under reported as most lesions are limited and a causal relationship with the treatment is often poorly understood. The reason for this apparent side-effect of the therapy still remains unclear. Although side effects may occur, their clinical benefits are undoubted. This article reviews the therapeutic effects of the two most widely used anti-TNF-α molecules, infliximab(a fusion protein dimer of the human TNF-α receptor) and adalimumab(a fully human monoclonal antibody to TNF-α), for the treatment of the major cutaneous manifestations associated with IBD(EN, PG and psoriasis).

关 键 词：Biological THERAPIES ERYTHEMA nodosum Inflammatory BOWEL disease PSORIASIS PYODERMA gangrenosum 

分 类 号：R574[医药卫生—消化系统]