Should Patients with IBD and Skin Lesions Stop Treatment?

Amanda Balbi

Patients with inflammatory bowel disease (IBD) who frequently develop skin lesions can avoid stopping anti-tumor necrosis factor (TNF) treatment if referred to a dermatologist early when symptoms present, according to a new study.

For the retrospective study, researchers examined 917 patients with IBD who were treated with anti-TNF therapy—specifically, the drug infliximab—over a 15-year period. Researchers conducted the study to understand whether developing lesions would require patients to stop taking infliximab.
____________________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Inflammatory Bowel Disease: A Primary Care Primer
Chronic Pancreatitis in an Elderly Woman With Inflammatory Bowel
____________________________________________________________________________________________________________________________________________________________________________

After a 3.5-year median follow up, researchers found that 29% of patients developed skin lesions associated with infliximab, but the level of infliximab didn’t impact lesion development.

About 31% of female patients and 26% of male patients developed lesions—most commonly appearing at flexural regions, genitalia, and the scalp. A dermatologist successfully treated most patients with lesions using topical or systemic therapy. Only 11% of patients had to stop taking infliximab because of lesions.

“Skin lesions occur frequently in association with anti-TNF therapy but rarely require discontinuation of therapy,” researchers determined. “Close surveillance and early referral to a dedicated dermatologist are recommended.”

—Amanda Balbi

Reference:

Cleynen I, Van Moerkercke W, Billiet T. Characteristics of skin lesions associated with anti–tumor necrosis factor therapy in patients with inflammatory bowel disease: a cohort study. Annals of Internal Medicine. Published online 8 December 2015. doi:10.7326/M15-0729. http://annals.org/article.aspx?articleid=2474360.