{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:01:57Z","timestamp":1774530117187,"version":"3.50.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1038\/s41390-025-04518-8","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T06:34:10Z","timestamp":1760942050000},"page":"837-838","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disproportionality analysis highlights paradoxical psoriasis as a clinically significant class effect of tumor necrosis-\u03b1 inhibitors in pediatric populations"],"prefix":"10.1038","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0026-9117","authenticated-orcid":false,"given":"Fiona","family":"Lynch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan D.","family":"Irvine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"4518_CR1","doi-asserted-by":"publisher","unstructured":"Piao, Y. et al. Paradoxical psoriasis in pediatric tumor necrosis factor-\u03b1 inhibitor therapy database. Pediatr. Res. https:\/\/doi.org\/10.1038\/s41390-025-04305-5 (2025).","DOI":"10.1038\/s41390-025-04305-5"},{"key":"4518_CR2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-017-02466-4","volume":"9","author":"C Conrad","year":"2018","unstructured":"Conrad, C. et al. TNF blockade induces a dysregulated type I interferon response without autoimmunity in paradoxical psoriasis. Nat. Commun. 9, 25 (2018).","journal-title":"Nat. Commun."},{"key":"4518_CR3","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1002\/acr.24100","volume":"73","author":"LH Buckley","year":"2021","unstructured":"Buckley, L. H., Xiao, R., Perman, M. J., Grossman, A. B. & Weiss, P. F. Psoriasis associated with tumor necrosis factor inhibitors in children with inflammatory diseases. Arthritis Care Res. 73, 215\u2013220 (2021).","journal-title":"Arthritis Care Res."},{"key":"4518_CR4","doi-asserted-by":"publisher","first-page":"286857","DOI":"10.1155\/2013\/286857","volume":"2013","author":"D S\u00e1nchez-Cano","year":"2013","unstructured":"S\u00e1nchez-Cano, D., Callejas-Rubio, J. L., Ruiz-Villaverde, R., R\u00edos-Fern\u00e1ndez, R. & Ortego-Centeno, N. Off-label uses of anti-TNF therapy in three frequent disorders: Beh\u00e7et\u2019s disease, sarcoidosis, and noninfectious uveitis. Mediators Inflamm. 2013, 286857 (2013).","journal-title":"Mediators Inflamm."},{"key":"4518_CR5","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1016\/j.jaad.2020.12.010","volume":"86","author":"MJ Murphy","year":"2022","unstructured":"Murphy, M. J., Cohen, J. M., Vesely, M. D. & Damsky, W. Paradoxical eruptions to targeted therapies in dermatology: a systematic review and analysis. J. Am. Acad. Dermatol. 86, 1080\u20131091 (2022).","journal-title":"J. Am. Acad. Dermatol."},{"key":"4518_CR6","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1111\/pde.14712","volume":"38","author":"BM Cyrenne","year":"2021","unstructured":"Cyrenne, B. M., Parpia, A. S. & Sibbald, C. Paradoxical psoriasis in pediatric patients: a systematic review. Pediatr. Dermatol. 38, 1086\u20131093 (2021).","journal-title":"Pediatr. Dermatol."},{"key":"4518_CR7","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/bjd.16332","volume":"179","author":"CEM Griffiths","year":"2018","unstructured":"Griffiths, C. E. M. et al. A multidimensional assessment of the burden of psoriasis: results from a multinational dermatologist and patient survey. Br. J. Dermatol. 179, 173\u2013181 (2018).","journal-title":"Br. J. Dermatol."},{"key":"4518_CR8","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1001\/jamadermatol.2023.0549","volume":"159","author":"J Eickstaedt","year":"2023","unstructured":"Eickstaedt, J. et al. Paradoxical psoriasiform eruptions in children receiving tumor necrosis factor \u03b1 inhibitors. JAMA Dermatol. 159, 637\u2013642 (2023).","journal-title":"JAMA Dermatol."},{"key":"4518_CR9","doi-asserted-by":"publisher","first-page":"e60","DOI":"10.36849\/JDD.7645","volume":"23","author":"MJ Woodbury","year":"2024","unstructured":"Woodbury, M. J., Grant, C., Perez-Chada, L., LaChance, A. H. & Merola, J. F. A case series of TNF inhibitor-induced psoriasis successfully treated with upadacitinib. J. Drugs Dermatol. JDD 23, e60\u2013e63 (2024).","journal-title":"J. Drugs Dermatol. JDD"},{"key":"4518_CR10","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1177\/2475530318810851","volume":"4","author":"SJ Li","year":"2019","unstructured":"Li, S. J., Perez-Chada, L. M. & Merola, J. F. TNF inhibitor-induced psoriasis: proposed algorithm for treatment and management. J. Psoriasis Psoriatic Arthritis 4, 70\u201380 (2019).","journal-title":"J. Psoriasis Psoriatic Arthritis"},{"key":"4518_CR11","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.jdcr.2024.03.015","volume":"48","author":"E Hanna","year":"2024","unstructured":"Hanna, E. & Benchikh El Fegoun, A. Anti-TNF alpha-induced paradoxical psoriasis treated with topical roflumilast 0.3%. JAAD Case Rep. 48, 115\u2013117 (2024).","journal-title":"JAAD Case Rep."}],"container-title":["Pediatric Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-04518-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-04518-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-04518-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:21:32Z","timestamp":1774527692000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-04518-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,20]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["4518"],"URL":"https:\/\/doi.org\/10.1038\/s41390-025-04518-8","relation":{},"ISSN":["0031-3998","1530-0447"],"issn-type":[{"value":"0031-3998","type":"print"},{"value":"1530-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,20]]},"assertion":[{"value":"5 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors report the following conflicts of interest: F.L.\u2014none. A.I.\u2014AbbVie, Arena Pharmaceuticals, BenevolentAI, Chugai Pharmaceutical, Dermavant, Eli Lilly, Genentech, LEO Pharma, Menlo Therapeutics, Novartis, Pfizer, Regeneron Pharmaceuticals Inc., Sanofi, Sitryx, UCB\u2014consultant; AbbVie, Eli Lilly, LEO Pharma, Pfizer, Regeneron Pharmaceuticals Inc., Sanofi \u2013 speaker; AbbVie, Inflazome, Novartis, Sanofi-Regeneron Pharmaceuticals Inc.\u2014investigator; Sanofi-Regeneron Pharmaceuticals Inc.\u2014patent holder.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}