Drug-induced cutaneous vasculitis developing during Etanercept treatment for rheumatoid arthritis

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Abstract

Biological disease-modifying anti-rheumatic drugs (bDMARDs) are widely used for the treatment of chronic inflammatory rheumatic diseases. Since the introduction of tumor necrosis factor alpha (TNF-α) inhibitors, the treatment of rheumatoid arthritis has been revolutionized. The approach of targeting TNF-α has considerably improved the success of the treatment of rheumatoid arthritis. Their effectiveness has been extensively proven in randomized clinical trials and in clinical practice. Randomized clinical trials and post-marketing studies proved that patients undergoing TNF-α inhibitors therapy are at increased risk of infectious disease, bacterial, viral, fungal, opportunistic, oncology and skin adverse effects such as psoriasis and angiitis of the skin. In this case report drug-induced cutaneous vasculitis developing during TNF-α inhibitor (Etanercept) treatment for rheumatoid arthritis is described.

About the authors

Maria N. Chamurlieva

V.A. Nasonova Scientific Research Institute of Rheumatology

Author for correspondence.
Email: mchamurlieva@mail.ru
ORCID iD: 0000-0001-5987-4413
SPIN-code: 2313-4665

MD, Cand. Sci. (Med.), research associate

Russian Federation, Kashirskoe shosse, 34A, Moscow

Yulia L. Korsakova

V.A. Nasonova Scientific Research Institute of Rheumatology

Email: yulkorsakova@bk.ru
ORCID iD: 0000-0001-5968-2403
SPIN-code: 6093-6060

MD, Cand. Sci. (Med.), senior research associate

Russian Federation, Kashirskoe shosse, 34A, Moscow

Stefka G. Radenska-Lopovok

Sechenov University

Email: radenska@mail.ru
ORCID iD: 0000-0002-4669-260X
SPIN-code: 3805-7380

MD, Dr. Sci. (Med.), Professor

Russian Federation, Trubetskaya str., 8, bldg 2, Moscow

Tatiana V. Korotaeva

V.A. Nasonova Scientific Research Institute of Rheumatology

Email: tatianakorotaeva@googlemail.com
ORCID iD: 0000-0003-0579-1131
SPIN-code: 9855-5954

Dr. Sci. (Med.), leading researcher

Russian Federation, Trubetskaya str., 8, bldg 2, Moscow

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Supplementary files

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1. JATS XML
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2. Fig. 1. A — dense nodules on the skin of the forearm, Б — erosion. B — rheumatoid nodule

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3. Fig. 2. Pink-cyanotic spots on the skin of the lower limbs

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4. Fig. 3. Hemorrhagic spot in the area of the nail phalanx of the hand

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5. Fig. 4. Swelling and necrosis of the vessels of the microvasculature. Hematoxylin and eosin stain, ×200

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6. Fig. 5. Swelling and infiltration by lymphocytes and histiocytes of the perivascular spaces and dermis. Hematoxylin and eosin stain, ×100

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Copyright (c) 2021 Chamurlieva M.N., Korsakova Y.L., Radenska-Lopovok S.G., Korotaeva T.V.

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