Reaction to biological drugs: infliximab for the treatment of toxic epidermal necrolysis subsequently triggering erosive lichen planus

Clin Exp Dermatol. 2012 Dec;37(8):879-81. doi: 10.1111/j.1365-2230.2012.04357.x. Epub 2012 Apr 30.

Abstract

Toxic epidermal necrolysis (TEN) is a rare, life-threatening skin reaction for which there is currently has no standardized treatment, despite its significant mortality. Biological agents such as tumour necrosis factor (TNF)-α antagonists are emerging as a novel treatment for patients with TEN. We report a 32-year-old woman who developed TEN secondary to sulfasalazine, which was treated with infliximab. The infliximab treatment subsequently triggered erosive lichen planus (LP) involving the mouth and vulva. Clinicians should be aware that TNF-α antagonists can cause LP as a paradoxical complication of treatment.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Antibodies, Monoclonal / adverse effects*
  • Biological Therapy / adverse effects*
  • Drug Eruptions / etiology
  • Female
  • Humans
  • Infliximab
  • Lichen Planus / chemically induced*
  • Lichen Planus, Oral / chemically induced
  • Stevens-Johnson Syndrome / drug therapy*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Vulvar Diseases / chemically induced*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha
  • Infliximab