Serpil TUNA, Sevil ALAN, Ülkü UÇAR, Mehmet İhsan ARMAN

Anti TNF-α tedavisi alan romatoloji hastalarında dermatolojik yan etkiler

GİRİŞ ve AMAÇ: Biz bu çalışmada, romatizmal hastalığı nedeniyle TNF-α bloker tedavisi alan hastalarda, tedavi süresince gelişmiş olan dermatolojik yan etkileri DYE saptamayı amaçladık.YÖNTEM ve GEREÇLER: Romatizmal hastalığı nedeniyle TNF-α bloker tedavisi alan 103 hasta çalışmaya dahil edildi. Hastalarda saptanan tüm cilt lezyonları, tedavi öncesi ve sonrası olarak kaydedildi. TNF-α bloker tedavisi sürecinde gelişen dermatolojik lezyonlar enfeksiyöz ve non-enfeksiyöz olarak gruplandırıldı. Tedavi sürecinde DYE geliştiren hastaların demografik ve kinik özellikleri incelendi. Ayrıca enfeksiyöz ve non-enfeksiyöz DYE gelişen hastaların demografik ve kinik özellikleri karşılaştırıldı.BULGULAR: Bu çalışma da yaşları 18-74 arasında değişen 103 hasta 40 kadın değerlendirildi. Toplam 50 % 48,54 hastada TNF-α bloker tedavi sürecinde gelişmiş 63 cilt lezyonu tespit edildi 25 onikomikoz, 7 psoriazis, 1 diskoid lupus eritematozus, 1 basal hücreli karcinom, 1 palmoplantar pustuloz, 28 diğer cilt lezyonu . Anti TNFα tedavi sürecinde DYE gelişmiş 50 hastanın 36 %72 ‘ sında enfeksiyöz, 14 %38 ’ ünde non-enfeksiyöz cilt lezyonları mevcuttu. Eş zamanlı methotrexate MTX kullanan hastalarda DYE anlamlı olarak daha sık bulundu. Bunlar arsında enfeksiyöz DYE’ lerin, non-enfeksiyöz olanlardan anlamlı olarak daha yüksek olduğu görüldü. Hastalığın tanısı ve kullanılan TNF-α bloker ile DYE ‘ ler arasında anlamlı bir fark bulunmadı.TARTIŞMA ve SONUÇ: TNF-α blokerler ile tedavi sürecinde, onikomikoz dan malignitelere kadar değişen yelpazede farklı dermatolojik yan etkiler gelişebilir. Sonuç olarak, TNF-α bloker tedavisi alan hastaların, DYE’ ler açısından takip edilmesi, erken tanı ve tedavi açısından önemlidir.

Anahtar Kelimeler:

TNF-α, blokerler, romatizmal hastlıklar, dermatolojik yan etkiler

Dermatological side effects in rheumatological patients taking anti TNF-α treatment

INTRODUCTION: In this study, we aimed to investigate dermatological side effects DSE seen in patients with rheumatic diseases taking TNF-α blocker. METHODS: A total number of 103 patients with chronic inflammatory rheumatic diseases on TNF-α blocker treatment were included into the study. All cutaneous leisons in patients were recorded as before and after TNF-α blocker treatment. TNF-α blockers-related DSE were grouped as infectious and non-infectious. The demographic and clinical characteristics of patients with DSE examined. In addition, demographic and clinical characteristics of the patients with infectious and non-infectious DSE were compared.RESULTS: 103 patients 40 female between the age of 18-74 were included into the study. Totally 63 cutaneous leisons occured during TNF-α blocker treatment were determined in 50 % 48.54 patients. 25 onychomycosis, 7 psoriasis, 1 diskoid lupus eritematozus, 1 basal cell carcinoma, 1 palmoplantar pustulosis, 28 other cutaneous lesions. 36 72% of patients with DSE had infectious skin lesions. 14 38% of patients with DSE had non-infectious skin. DSE were significantly higher in patients receiving concomitant methotrexate MTX . İnfectious DSE were significantly higher than non infectious DSE in patients receiving concomitant MTX. There was no relationship between DSE with the type of TNF-α blocker and rheumatic diseases.DISCUSSION AND CONCLUSION: As a result, DSE ranging from onychomycosis to malignancies can be seen during be seen during TNF-α blocker therapy. Monitoring for DSE of the patients receiving TNF-α blocker treatment is important for early diagnosis and treatment.

Keywords:

TNF-α, blokers, rheumatic diseases, dermatological side effects,

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