Anti-TNF-Related Leukocytoclastic Vasculitis in Ulcerative Colitis: A Case Report

Background: The development of drugs directed against tumor necrosis factor (TNF)-alpha has dramatically modified the therapeutic approach to inflammatory bowel diseases: a larger use of such drugs has also led to a major knowledge about their adverse effects, especially on skin. The aim of this report was to describe a rare steroid-dependent form of leukocytoclastic vasculitis induced by an anti-TNF-alpha agent in a young woman with ulcerative colitis. Case presentation: A young girl with ulcerative colitis developed a form of leukocytoclastic vasculitis induced by an anti-TNF-alpha agent. Recurrent palpable purpuric lesions on her legs were the main cutaneous manifestation. Skin lesions were steroid-dependent, but improved after withdrawal of the anti-TNF-alpha agent and second-line immunosuppressant therapy. Conclusions: The need to develop specific recommendations to guide the use of medications for managing skin reactions induced by anti-TNF-alpha drugs is herein emphasized.

Automated summary

The development of drugs targeting TNF-alpha has revolutionized the treatment of inflammatory bowel diseases but also led to a better understanding of their adverse effects on the skin. This case report highlights a rare steroid-dependent form of leukocytoclastic vasculitis induced by an anti-TNF-alpha agent in a young woman with ulcerative colitis, with skin manifestations improving after discontinuing the drug and starting second-line immunosuppressant therapy. It underscores the importance of developing specific recommendations for managing skin reactions induced by anti-TNF-alpha drugs.