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Skin lesions, including psoriasiform, eczematous and lupoid eruptions, may paradoxically result from anti\u2010TNF use and cause significant morbidity leading to discontinuation of therapy. There are no consensus guidelines on the management of these lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This systematic review considers the existing evidence regarding cutaneous complications of anti\u2010TNF therapy in IBD and the development of an algorithm for management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review was performed by searching Medline (Pubmed) and Embase for articles published from inception to January 2021. The following search terms were used \u2018anti\u2010tumour necrosis factor alpha\u2019, \u2018infliximab\u2019, \u2018adalimumab\u2019, \u2018certolizumab\u2019, \u2018golimumab\u2019, \u2018inflammatory bowel disease\u2019, \u2018Crohn disease\u2019, \u2018Ulcerative colitis\u2019, \u2018psoriasis\u2019, \u2018psoriasiform\u2019, \u2018dermatitis\u2019, \u2018lupus\u2019, \u2018skin lesion\u2019 and \u2018skin rash\u2019. Reference lists of relevant studies were reviewed to identify additional suitable studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010four studies were included in the review. Eczema can generally be managed with topical agents and the anti\u2010TNF can be continued, while the development of lupus requires immediate cessation of the anti\u2010TNF and consideration of alternative immunomodulators. Management of psoriasis and psoriasiform lesions may follow a step\u2010wise algorithm where topical treatments will be trialled in less severe cases, with recourse to an alternative anti\u2010TNF or a switch to an alternative class of biological agent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Assessment of anti\u2010TNF skin lesions should be performed in conjunction with a dermatologist and rheumatologist in complex cases. High\u2010quality prospective studies are needed to clarify the validity of these algorithms in the future.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15859","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T02:59:10Z","timestamp":1656385150000},"page":"1854-1865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Anti\u2010tumour necrosis factor\u2010induced skin rashes in inflammatory bowel disease: a systematic review and evidence\u2010based management algorithm"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-4725","authenticated-orcid":false,"given":"Minnie","family":"Au","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Lyell McEwin Hospital  Adelaide South Australia 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