{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T21:51:46Z","timestamp":1769118706107,"version":"3.49.0"},"reference-count":93,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The biologic era has greatly improved the treatment of Crohn\u2019s disease and ulcerative colitis. Biologics can however induce a wide variety of skin eruptions, especially those targeting the TNF-\u03b1 and Th17 pathway. These include infusion reactions, eczema, psoriasis, lupus, alopecia areata, vitiligo, lichenoid reactions, granulomatous disorders, vasculitis, skin cancer, and cutaneous infections. It is important to recognize these conditions as treatment-induced adverse reactions and adapt the treatment strategy accordingly. Some conditions can be treated topically while others require cessation or switch of the biological therapy. TNF-\u03b1 antagonists have the highest rate adverse skin eruptions followed by ustekinumab and anti-integrin receptor blockers. In this review, we provide an overview of the most common skin eruptions which can be encountered in clinical practice when treating IBD (Inflammatory bowel disease) patients and propose a therapeutic approach for each condition.<\/jats:p>","DOI":"10.3390\/jcm10051040","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T20:33:57Z","timestamp":1614803637000},"page":"1040","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Cutaneous Manifestations in Biological-Treated Inflammatory Bowel Disease Patients: A Narrative Review"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5303-9310","authenticated-orcid":false,"given":"Jo L. W.","family":"Lambert","sequence":"first","affiliation":[{"name":"Department of Dermatology, Ghent University Hospital, B-9000 Gent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofie","family":"De Schepper","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Ghent University Hospital, B-9000 Gent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhart","family":"Speeckaert","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Ghent University Hospital, B-9000 Gent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1093\/ecco-jcc\/jjz095","article-title":"Vedolizumab Treatment in Extra-Intestinal Manifestations in Inflammatory Bowel Disease: A Systematic Review","volume":"13","author":"Chateau","year":"2019","journal-title":"J. Crohns Colitis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1093\/ecco-jcc\/jjv238","article-title":"Smoking Is Associated With Extra-Intestinal Manifestations in Inflammatory Bowel Disease","volume":"10","author":"Severs","year":"2016","journal-title":"J. Crohns Colitis"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3389\/fphys.2012.00013","article-title":"Skin Manifestations of Inflammatory Bowel Disease","volume":"3","author":"Huang","year":"2012","journal-title":"Front. Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s12016-017-8617-4","article-title":"Skin Manifestations of Inflammatory Bowel Disease","volume":"53","author":"Greuter","year":"2017","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/ecco-jcc\/jjv213","article-title":"The First European Evidence-Based Consensus on Extra-Intestinal Manifestations in Inflammatory Bowel Disease","volume":"10","author":"Harbord","year":"2016","journal-title":"J. Crohns Colitis"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1093\/ibd\/izy112","article-title":"Dermatological Manifestations in Pediatric Patients with Inflammatory Bowel Diseases on Anti-TNF Therapy","volume":"24","author":"Sridhar","year":"2018","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1177\/1203475420917387","article-title":"Skin Manifestations in Pediatric Patients Treated With a TNF-Alpha Inhibitor for Inflammatory Bowel Disease: A Retrospective Study [Formula: See Text]","volume":"24","author":"Cossio","year":"2020","journal-title":"J. Cutan Med. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"182","DOI":"10.2310\/6620.2009.09010a","article-title":"A Mechanism-Based Classification of Dermatologic Reactions to Biologic Agents Used in the Treatment of Cutaneous Disease: Part 1","volume":"20","author":"Bremmer","year":"2009","journal-title":"Dermatitis"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.jaad.2008.10.060","article-title":"Cutaneous Side Effects of Anti-Tumor Necrosis Factor Biologic Therapy: A Clinical Review","volume":"61","author":"Moustou","year":"2009","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_10","first-page":"203","article-title":"Disease-Related and Drug-Induced Skin Manifestations in Inflammatory Bowel Disease","volume":"11","author":"Hindryckx","year":"2017","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1111\/j.1572-0241.2003.07457.x","article-title":"The Incidence and Management of Infusion Reactions to Infliximab: A Large Center Experience","volume":"98","author":"Cheifetz","year":"2003","journal-title":"Am. J. Gastroenterol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1097\/MEG.0000000000001917","article-title":"Systematic Review and Meta-Analysis of Dermatological Reactions in Patients with Inflammatory Bowel Disease Treated with Anti-Tumour Necrosis Factor Therapy","volume":"33","author":"Nigam","year":"2021","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1001\/jama.2014.5613","article-title":"Association between Tumor Necrosis Factor-\u03b1 Antagonists and Risk of Cancer in Patients with Inflammatory Bowel Disease","volume":"311","author":"Pasternak","year":"2014","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1053\/j.gastro.2012.05.004","article-title":"Risk of Melanoma and Nonmelanoma Skin Cancer among Patients with Inflammatory Bowel Disease","volume":"143","author":"Long","year":"2012","journal-title":"Gastroenterology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1038\/s41395-018-0360-9","article-title":"Malignancies in Inflammatory Bowel Disease: Frequency, Incidence and Risk Factors-Results from the Swiss IBD Cohort Study","volume":"114","author":"Scharl","year":"2019","journal-title":"Am. J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"R545","DOI":"10.1186\/ar1715","article-title":"Club Rhumatismes et Inflammation Systemic Lupus Erythematosus Induced by Anti-Tumour Necrosis Factor Alpha Therapy: A French National Survey","volume":"7","author":"Sibilia","year":"2005","journal-title":"Arthritis Res. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1002\/jgh3.12291","article-title":"Anti-TNF-Induced Lupus in Patients with Inflammatory Bowel Disease","volume":"4","author":"Picardo","year":"2020","journal-title":"JGH Open"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"315","DOI":"10.2174\/1874312901206010315","article-title":"Anti-Tumor Necrosis Factor-\u03b1 Induced Systemic Lupus Erythematosus","volume":"6","author":"Almoallim","year":"2012","journal-title":"Open Rheumatol. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1111\/j.1398-9995.2006.01058.x","article-title":"Adverse Side-Effects to Biological Agents","volume":"61","author":"Pichler","year":"2006","journal-title":"Allergy"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1056\/NEJMoa020888","article-title":"Influence of Immunogenicity on the Long-Term Efficacy of Infliximab in Crohn\u2019s Disease","volume":"348","author":"Baert","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1056\/NEJM200011303432202","article-title":"Infliximab and Methotrexate in the Treatment of Rheumatoid Arthritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group","volume":"343","author":"Lipsky","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"282","DOI":"10.3389\/fphar.2019.00282","article-title":"Paradoxical Skin Reactions to Biologics in Patients With Rheumatologic Disorders","volume":"10","author":"Garcovich","year":"2019","journal-title":"Front. Pharmacol."},{"key":"ref_23","first-page":"253","article-title":"Imaging and Serum Analysis of Immune Complex Formation of Radiolabelled Infliximab and Anti-Infliximab in Responders and Non-Responders to Therapy for Rheumatoid Arthritis","volume":"66","author":"Voskuyl","year":"2007","journal-title":"Ann. Rheum. Dis."},{"key":"ref_24","first-page":"73ra20","article-title":"Netting Neutrophils Are Major Inducers of Type I IFN Production in Pediatric Systemic Lupus Erythematosus","volume":"3","author":"Caielli","year":"2011","journal-title":"Sci. Transl. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3372","DOI":"10.1073\/pnas.0408506102","article-title":"Cross-Regulation of TNF and IFN-Alpha in Autoimmune Diseases","volume":"102","author":"Palucka","year":"2005","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s10620-018-5319-6","article-title":"Incidence and Management of Infusion Reactions to Infliximab in an Alternate Care Setting","volume":"64","author":"Checkley","year":"2019","journal-title":"Dig. Dis. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1136\/gut.2008.163683","article-title":"Dermatological Complications and Safety of Anti-TNF Treatments","volume":"58","author":"Kerbleski","year":"2009","journal-title":"Gut"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102","DOI":"10.7150\/ijms.17025","article-title":"Age-Related Trends in Injection Site Reaction Incidence Induced by the Tumor Necrosis Factor-\u03b1 (TNF-\u03b1) Inhibitors Etanercept and Adalimumab: The Food and Drug Administration Adverse Event Reporting System, 2004\u20132015","volume":"14","author":"Matsui","year":"2017","journal-title":"Int. J. Med. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e12817","DOI":"10.1111\/dth.12817","article-title":"Injection Site Reactions with the Use of Biological Agents","volume":"32","author":"Thomaidou","year":"2019","journal-title":"Dermatol. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1053\/j.gastro.2019.08.027","article-title":"Efficacy and Safety of Vedolizumab Subcutaneous Formulation in a Randomized Trial of Patients With Ulcerative Colitis","volume":"158","author":"Sandborn","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.dld.2018.12.002","article-title":"Premedication as Primary Prophylaxis Does Not Influence the Risk of Acute Infliximab Infusion Reactions in Immune-Mediated Inflammatory Diseases: A Systematic Review and Meta-Analysis","volume":"51","author":"Fumery","year":"2019","journal-title":"Dig. Liver Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1177\/2040622318772705","article-title":"Safety and Tolerability of Adalimumab for the Treatment of Psoriasis: A Review Summarizing 15 Years of Real-Life Experience","volume":"9","author":"Sator","year":"2018","journal-title":"Ther. Adv. Chronic Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1080\/09546634.2016.1230173","article-title":"Eczema as an Adverse Effect of Anti-TNF\u03b1 Therapy in Psoriasis and Other Th1-Mediated Diseases: A Review","volume":"28","author":"Nakamura","year":"2017","journal-title":"J. Dermatolog. Treat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1007\/s40257-017-0296-7","article-title":"Clinical Signs, Pathophysiology and Management of Cutaneous Side Effects of Anti-Tumor Necrosis Factor Agents","volume":"18","author":"Segaert","year":"2017","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"R666","DOI":"10.1186\/ar1724","article-title":"Dermatological Conditions during TNF-Alpha-Blocking Therapy in Patients with Rheumatoid Arthritis: A Prospective Study","volume":"7","author":"Flendrie","year":"2005","journal-title":"Arthritis Res. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.21037\/atm.2016.10.69","article-title":"Th2\/Th17 Reciprocal Regulation: Twists and Turns in the Complexity of Asthma Phenotypes","volume":"4","author":"Lynch","year":"2016","journal-title":"Ann. Transl. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1111\/jdv.16246","article-title":"Phenotypic Switch to Eczema in Patients Receiving Biologics for Plaque Psoriasis: A Systematic Review","volume":"34","author":"Foulkes","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1099\/jmm.0.017277-0","article-title":"Mycobacterium Marinum Infection Complicated by Anti-Tumour Necrosis Factor Therapy","volume":"59","author":"Ramos","year":"2010","journal-title":"J. Med. Microbiol."},{"key":"ref_39","unstructured":"Nguyen, E.D., Gabel, C.K., and Kroshinsky, D. (2020). Assessing the Incidence of Skin and Soft Tissue Infection in Patients on Biologics. J. Am. Acad. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/S2468-1253(19)30266-3","article-title":"Use of Tumour Necrosis Factor-\u03b1 Inhibitors and the Risk of Serious Infection in Paediatric Inflammatory Bowel Disease in Denmark: A Nationwide Cohort Study","volume":"4","author":"Wintzell","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_41","first-page":"56","article-title":"Varicella Zoster Virus Infection in Patients with Inflammatory Bowel Disease","volume":"9","author":"Ham","year":"2013","journal-title":"Gastroenterol. Hepatol. (N Y)"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"h2809","DOI":"10.1136\/bmj.h2809","article-title":"Association between Tumour Necrosis Factor-\u03b1 Inhibitors and Risk of Serious Infections in People with Inflammatory Bowel Disease: Nationwide Danish Cohort Study","volume":"350","author":"Pasternak","year":"2015","journal-title":"BMJ"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1038\/ajg.2015.205","article-title":"Cumulative Incidence of, Risk Factors for, and Outcome of Dermatological Complications of Anti-TNF Therapy in Inflammatory Bowel Disease: A 14-Year Experience","volume":"110","author":"Baumann","year":"2015","journal-title":"Am. J. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1111\/apt.13352","article-title":"Paradoxical Psoriasis in a Large Cohort of Patients with Inflammatory Bowel Disease Receiving Treatment with Anti-TNF Alpha: 5-Year Follow-up Study","volume":"42","author":"Pugliese","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"10","DOI":"10.7326\/M15-0729","article-title":"Characteristics of Skin Lesions Associated With Anti-Tumor Necrosis Factor Therapy in Patients With Inflammatory Bowel Disease: A Cohort Study","volume":"164","author":"Cleynen","year":"2016","journal-title":"Ann. Intern. Med."},{"key":"ref_46","first-page":"438","article-title":"Psoriasis Induced by Anti-Tumor Necrosis Factor Therapy: A Class Effect?","volume":"34","author":"Richette","year":"2007","journal-title":"J. Rheumatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/1346-8138.14816","article-title":"Ustekinumab for Skin Reactions Associated with Anti-Tumor Necrosis Factor-\u03b1 Agents in Patients with Inflammatory Bowel Diseases: A Single-Center Retrospective Study","volume":"46","author":"Ezzedine","year":"2019","journal-title":"J. Dermatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/j.dld.2016.08.122","article-title":"Vedolizumab Is an Effective Alternative in Inflammatory Bowel Disease Patients with Anti-TNF-Alpha Therapy-Induced Dermatological Side Effects","volume":"48","author":"Pijls","year":"2016","journal-title":"Dig. Liver Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.1007\/s10620-018-5056-x","article-title":"Low Rates of Dermatologic Care and Skin Cancer Screening Among Inflammatory Bowel Disease Patients","volume":"63","author":"Anderson","year":"2018","journal-title":"Dig. Dis. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1159\/000509544","article-title":"Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology Malignancies in Inflammatory Bowel Disease","volume":"101","author":"Greuter","year":"2020","journal-title":"Digestion"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Sandborn, W.J., Feagan, B.G., Danese, S., O\u2019Brien, C.D., Ott, E., Marano, C., Baker, T., Zhou, Y., Volger, S., and Tikhonov, I. (2020). Safety of Ustekinumab in Inflammatory Bowel Disease: Pooled Safety Analysis of Results from Phase 2\/3 Studies. Inflamm. Bowel Dis.","DOI":"10.1093\/ibd\/izaa236"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1080\/14740338.2019.1612874","article-title":"Safety of Drugs Used for the Treatment of Crohn\u2019s Disease","volume":"18","author":"Pudipeddi","year":"2019","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1002\/ijc.30183","article-title":"Inflammatory Bowel Disease, Cancer and Medication: Cancer Risk in the Dutch Population-Based IBDSL Cohort","volume":"139","author":"Wintjens","year":"2016","journal-title":"Int. J. Cancer"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1038\/ajg.2016.537","article-title":"ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease","volume":"112","author":"Farraye","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1186\/s13075-019-2028-2","article-title":"Anti-TNF-Alpha-Induced Lupus","volume":"21","year":"2019","journal-title":"Arthritis Res. Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s40268-020-00320-5","article-title":"Systematic Review: Monoclonal Antibody-Induced Subacute Cutaneous Lupus Erythematosus","volume":"20","author":"Bolton","year":"2020","journal-title":"Drugs R D"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.jdcr.2019.01.015","article-title":"Ustekinumab-Induced Subacute Cutaneous Lupus","volume":"5","author":"Tierney","year":"2019","journal-title":"JAAD Case Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"68","DOI":"10.4103\/ijdvl.IJDVL_961_18","article-title":"Exacerbation of Systemic Lupus Erythematosus in a Patient with Concomitant Chronic Plaque Psoriasis Treated with Ustekinumab","volume":"86","author":"Goh","year":"2020","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/1756-185X.13817","article-title":"State-of-the-Art Treatment of Systemic Lupus Erythematosus","volume":"23","author":"Tanaka","year":"2020","journal-title":"Int. J. Rheum Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1093\/rheumatology\/kez502","article-title":"The First Case of Natalizumab-Induced Subacute Cutaenous Lupus Erythematosus","volume":"59","author":"Bolton","year":"2020","journal-title":"Rheumatology (Oxf.)"},{"key":"ref_61","first-page":"S10","article-title":"P-016 Vedolizumab and Drug-Induced Lupus: An Unexpected Phenomenon","volume":"23","author":"Alexandra","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1093\/ecco-jcc\/jjz137","article-title":"The Safety Profile of Vedolizumab in Ulcerative Colitis and Crohn\u2019s Disease: 4 Years of Global Post-Marketing Data","volume":"14","author":"Cohen","year":"2020","journal-title":"J. Crohns Colitis"},{"key":"ref_63","first-page":"710","article-title":"CRI (Club Rhumatismes et Inflammation) Vasculitides Induced by TNFalpha Antagonists: A Study in 39 Patients in France","volume":"73","year":"2006","journal-title":"Jt. Bone Spine"},{"key":"ref_64","first-page":"1955","article-title":"Leukocytoclastic Vasculitis Associated with Tumor Necrosis Factor-Alpha Blocking Agents","volume":"31","author":"Mohan","year":"2004","journal-title":"J. Rheumatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jaad.2008.09.032","article-title":"Lichen Planus-like Eruptions: An Emerging Side Effect of Tumor Necrosis Factor-Alpha Antagonists","volume":"61","author":"Asarch","year":"2009","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1684\/ejd.2016.2860","article-title":"Pigmented Lichenoid Drug Eruption: A New Clinical Presentation of Interface Dermatitis Induced by Anti-TNF Alpha Drugs","volume":"26","author":"Darrigade","year":"2016","journal-title":"Eur. J. Dermatol."},{"key":"ref_67","first-page":"45","article-title":"Lichenoid Reactions in Association with Tumor Necrosis Factor Alpha Inhibitors","volume":"8","author":"McCarty","year":"2015","journal-title":"J. Clin. Aesthet Dermatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.det.2015.03.015","article-title":"Granulomatous Drug Eruptions","volume":"33","author":"Shear","year":"2015","journal-title":"Dermatol. Clin."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1001\/archderm.142.2.198","article-title":"Interstitial Granulomatous Dermatitis Associated with the Use of Tumor Necrosis Factor Alpha Inhibitors","volume":"142","author":"Deng","year":"2006","journal-title":"Arch. Dermatol."},{"key":"ref_70","first-page":"172","article-title":"Reactive Granulomatous Dermatitis during Anti-TNF Therapy: A Case Report and Review of the Literature","volume":"4","author":"Cassone","year":"2017","journal-title":"Clin. Med. Rev. Case Rep."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1590\/abd1806-4841.20153084","article-title":"Alopecia Secondary to Anti-Tumor Necrosis Factor-Alpha Therapy","volume":"90","author":"Ribeiro","year":"2015","journal-title":"An. Bras. Dermatol."},{"key":"ref_72","first-page":"6","article-title":"Adalimumab-Induced Psoriatic Alopecia\/Alopecia Areata-like Reaction in a Patient with Crohn\u2019s Disease","volume":"21","author":"Lopes","year":"2015","journal-title":"Dermatol. Online J."},{"key":"ref_73","first-page":"285","article-title":"Alopecia areata during anti-TNF alpha therapy: Nine cases","volume":"138","author":"Chaby","year":"2011","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.jid.2017.11.012","article-title":"Increased Risk of Vitiligo Following Anti-Tumor Necrosis Factor Therapy: A 10-Year Population-Based Cohort Study","volume":"138","author":"Bae","year":"2018","journal-title":"J. Investig. Dermatol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1684\/ejd.2013.2221","article-title":"Alopecia Areata Developing during Ustekinumab Therapy: Report of Two Cases","volume":"23","author":"Tauber","year":"2013","journal-title":"Eur. J. Dermatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"14","DOI":"10.5070\/D34G31C0TM","article-title":"Letter: Alopecia Areata during Ustekinumab Administration: Co-Existence or an Adverse Reaction?","volume":"18","author":"Verros","year":"2012","journal-title":"Dermatol. Online J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jaci.2015.11.001","article-title":"Extensive Alopecia Areata Is Reversed by IL-12\/IL-23p40 Cytokine Antagonism","volume":"137","author":"Ungar","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1111\/fcp.12558","article-title":"Drug-Induced Vitiligo: A Case\/Non-Case Study in Vigibase\u00ae, the WHO Pharmacovigilance Database","volume":"34","author":"Anthony","year":"2020","journal-title":"Fundam Clin. Pharmacol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.jdcr.2017.07.009","article-title":"Effective Use of Ustekinumab in a Patient with Concomitant Psoriasis, Vitiligo, and Alopecia Areata","volume":"3","author":"Elkady","year":"2017","journal-title":"JAAD Case Rep."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1097\/SMJ.0b013e3181bb554c","article-title":"Adverse Cutaneous Reactions Induced by TNF-Alpha Antagonist Therapy","volume":"102","year":"2009","journal-title":"South Med. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1016\/j.jaad.2009.04.048","article-title":"Erythema Multiforme during Anti-Tumor Necrosis Factor Treatment for Plaque Psoriasis","volume":"62","author":"Ahdout","year":"2010","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Hasegawa, A., and Abe, R. (2020). Recent Advances in Managing and Understanding Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. F1000Res, 9.","DOI":"10.12688\/f1000research.24748.1"},{"key":"ref_83","first-page":"3875024","article-title":"Stevens-Johnson Syndrome and Herpes Simplex Type 1 Infection during Adalimumab Therapy for Crohn\u2019s Disease","volume":"2020","author":"Roselli","year":"2020","journal-title":"Case Rep. Gastrointest Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"28175","DOI":"10.1038\/srep28175","article-title":"Increased Cumulative Incidence of Dermatomyositis in Ulcerative Colitis: A Nationwide Cohort Study","volume":"6","author":"Tseng","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"100018","DOI":"10.1016\/j.jtauto.2019.100018","article-title":"Polymyositis and Dermatomyositis\u2014Challenges in Diagnosis and Management","volume":"2","author":"Yang","year":"2019","journal-title":"J. Transl. Autoimmun."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s13075-020-02164-5","article-title":"Juvenile Dermatomyositis Research Group (JDRG) Retrospective Analysis of Infliximab and Adalimumab Treatment in a Large Cohort of Juvenile Dermatomyositis Patients","volume":"22","author":"Deakin","year":"2020","journal-title":"Arthritis Res. Ther."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"179180","DOI":"10.1155\/2014\/179180","article-title":"New Onset of Dermatomyositis\/Polymyositis during Anti-TNF-\u03b1 Therapies: A Systematic Literature Review","volume":"2014","author":"Brunasso","year":"2014","journal-title":"Sci. World J."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1093\/rheumatology\/kez020","article-title":"Successful Treatment of Refractory Mechanic\u2019s Hands with Ustekinumab in a Patient with the Antisynthetase Syndrome","volume":"58","author":"Kroodsma","year":"2019","journal-title":"Rheumatology (Oxf.)"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/RHU.0000000000000430","article-title":"A Rare Case of Amyopathic Juvenile Dermatomyositis Associated With Psoriasis Successfully Treated With Ustekinumab","volume":"23","author":"Montoya","year":"2017","journal-title":"J. Clin. Rheumatol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jaad.2020.01.006","article-title":"Histologic Comparison of Tumor Necrosis Factor-\u03b1 Inhibitor-Induced Psoriasis and Psoriasis Vulgaris","volume":"83","author":"Hu","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1097\/DAD.0b013e3181cb3ff7","article-title":"Histopathologic Spectrum of Psoriasiform Skin Reactions Associated with Tumor Necrosis Factor-\u03b1 Inhibitor Therapy. A Study of 16 Biopsies","volume":"32","author":"Laga","year":"2010","journal-title":"Am. J. Dermatopathol."},{"key":"ref_92","first-page":"1009","article-title":"Is TNF-\u03b1 Inhibitor-Induced Psoriasiform Dermatitis Always Psoriasiform?","volume":"19","author":"Wei","year":"2020","journal-title":"J. Drugs Dermatol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/1346-8138.13762","article-title":"Cutaneous Side-Effects of Biologics in Immune-Mediated Disorders: A Histopathological Perspective","volume":"44","author":"Succaria","year":"2017","journal-title":"J. Dermatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/5\/1040\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:32:05Z","timestamp":1760160725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/5\/1040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,3]]},"references-count":93,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["jcm10051040"],"URL":"https:\/\/doi.org\/10.3390\/jcm10051040","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,3]]}}}