Coline Faivre1, Axel Patrice Villani2, François Aubin3, Dan Lipsker4, Martine Bottaro5, Jean-David Cohen6, François Durupt7, Géraldine Jeudy8, Emilie Sbidian9, Eric Toussirot10, Valérie Badot11, Sébastien Barbarot12, Sébastien Debarbieux13, Emmanuel Delaporte14, Guetty Goegebeur15, Jacques Morel16, Aude Nassif17, Gérard Duru2, Denis Jullien2. 1. Dermatology Department, Hôpital Edouard Herriot, Université Claude Bernard Lyon I, Lyon, France. Electronic address: coline.faivre@gmail.com. 2. Dermatology Department, Hôpital Edouard Herriot, Université Claude Bernard Lyon I, Lyon, France. 3. Dermatology Department, Hôpital Saint-Jacques, Université de Franche-Comté, Besançon, France. 4. Dermatology Department, Centre Hospitalo-Universitaire (CHU) de Strasbourg, Université de Strasbourg, Strasbourg, France. 5. Rheumatology Department, Center Hospitalier de Valence, Valence, France. 6. Rheumatology Department, CHU Lapeyronie, Montpellier, France. 7. Dermatology Department, Center Hospitalier de Valence, Valence, France. 8. Dermatology Department, CHU de Dijon, Dijon, France. 9. Dermatology Department, CHU Henri-Mondor, Créteil, France. 10. 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. 11. Rheumatology Department, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium. 12. Dermatology Department, CHU Hôtel Dieu, Nantes, France. 13. Dermatology Department, Center Hospitalier Lyon-Sud, Lyon, France. 14. Dermatology Department, Hôpital Claude-Huriez, Université Lille II, Lille, France. 15. Hepatogastroenterology Department, Center Hospitalier Loire Vendée Océan, Challans, France. 16. Rheumatology Department, CHU Lapeyronie, Université de Montpellier, Montpellier, France. 17. Infectious Diseases Center Necker-Pasteur, Pasteur Institute, Assistance Publique-Hôpitaux de Paris, Paris, France.
Abstract
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.
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.
Authors: Igor Kremenevski; Oliver Sander; Michael Sticherling; Martin Raithel; FirstName MiddleName LastName Journal: Dtsch Arztebl Int Date: 2022-02-11 Impact factor: 8.251
Authors: Margaret M Lowe; Haley B Naik; Sean Clancy; Mariela Pauli; Kathleen M Smith; Yingtao Bi; Robert Dunstan; Johann E Gudjonsson; Maia Paul; Hobart Harris; Esther Kim; Uk Sok Shin; Richard Ahn; Wilson Liao; Scott L Hansen; Michael D Rosenblum Journal: JCI Insight Date: 2020-10-02
Authors: Johann E Gudjonsson; Lam C Tsoi; Feiyang Ma; Allison C Billi; K R van Straalen; A R J V Vossen; H H van der Zee; Paul W Harms; Rachael Wasikowski; Christine M Yee; Syed M Rizvi; Xianying Xing; Enze Xing; Olesya Plazyo; Chang Zeng; Matthew T Patrick; Margaret M Lowe; Richard E Burney; Jeffrey H Kozlow; Jill R Cherry-Bukowiec; Yanyun Jiang; Joseph Kirma; Stephan Weidinger; Kelly C Cushing; Michael D Rosenblum; Celine Berthier; Amanda S MacLeod; John J Voorhees; Fei Wen; J Michelle Kahlenberg; Emanual Maverakis; Robert L Modlin; Errol P Prens Journal: JCI Insight Date: 2020-10-02