{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:25:14Z","timestamp":1777940714437,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Royal College of Physicians of Edinburgh"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>\n                    Cutaneous tuberculosis (TB) is an uncommon condition, the diagnosis of which can be challenging. Biologic disease-modifying anti-rheumatic drugs (bDMARDs) are associated with a higher risk of opportunistic infections, including TB. We present a case of cutaneous TB in a 56-year-old male with psoriatic arthritis on adalimumab. He developed skin lesions on his thumb and axilla, and\n                    <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                    was isolated in cultures sent from a skin biopsy. Four months after commencement of TB treatment, he presented with a new onset of seizures. An MRI head showed two tuberculomas, with no further lesions identified in cross-sectional imaging. A tapering course of steroids was started alongside a 12-month course of anti-TB treatment for post-tuberculous treatment paradoxical reaction. In conclusion, although uncommon, cutaneous TB should be considered in patients on bDMARD treatment with atypical skin lesions.\n                  <\/jats:p>","DOI":"10.1177\/14782715251401766","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T09:11:50Z","timestamp":1764234710000},"page":"299-301","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["An unusual case of cutaneous tuberculosis and paradoxical TB in a patient with spondyloarthritis treated with adalimumab"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2884-5506","authenticated-orcid":false,"given":"Antia","family":"Garcia Fernandez","sequence":"first","affiliation":[{"name":"Department of Rheumatology, University Hospital of Southampton, Southampton, UK"},{"name":"Department of Infection, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital of Southampton, Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Elkington","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, University Hospital of Southampton, Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7638-5774","authenticated-orcid":false,"given":"Andrew","family":"Rosser","sequence":"additional","affiliation":[{"name":"Department of Infection, University Hospital of Southampton, Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinny","family":"Wallis","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Hospital of Southampton, Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"Global Tuberculosis Report 2024","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. Global Tuberculosis Report 2024. Geneva: World Health Organization; 2024."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2014.12.006"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.TNMI7-0010-2016"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens12070920"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.TNMI7-0026-2016"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13129"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223335"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3344-x"},{"key":"e_1_3_2_10_2","article-title":"Reconsidering the optimal immune response to","volume":"201","author":"Tezera LB","year":"2020","unstructured":"Tezera LB, Mansour S, Elkington P. Reconsidering the optimal immune response to Mycobacterium tuberculosis. Am J Respir Crit Care Med 2020; 201: 407\u201313.","journal-title":"Mycobacterium tuberculosis. 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