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Abstract：
BACKGROUND: Antibody-based therapies that inhibit proinflammatory cytokine signaling are commonly used in dermatology. Paradoxically, these medications may induce or exacerbate inflammatory disorders.
OBJECTIVE: To summarize the spectrum of manifestations, incidence, timing, potential mechanisms of, and general management approaches to paradoxical cutaneous reactions induced by cytokine-targeted antibodies in dermatology.
METHODS: We performed a systematic review and analysis of published cases of cutaneous paradoxical reactions (PRs) reported in association with tumor necrosis factor α, interleukin (IL) 12/23 (p40), IL-17A/17R, IL-23 (p19), and IL-4Rα inhibitors.
RESULTS: We identified 313 articles reporting 2049 cases of PRs. Tumor necrosis factor α inhibitors resulted in 91.2% (1869/2049) of all cases, followed by IL-17/17R (3.5%), IL-4Rα (2.7%), IL-12/23 (2.4%), and IL-23 (0.01%) inhibitors. Psoriasiform and eczematous eruptions were the most commonly reported, but a wide spectrum of patterns were described. Phenotypically overlapping reaction patterns were common. Time to onset typically ranged from weeks to months but could occur more than a year later. Improvement or resolution upon discontinuation of the inciting drug was common.
CONCLUSIONS: This was a retrospective analysis.
CONCLUSIONS: Familiarity with the clinical features of PRs from cytokine-blocking antibodies may facilitate efficient recognition and management.
OBJECTIVE: To summarize the spectrum of manifestations, incidence, timing, potential mechanisms of, and general management approaches to paradoxical cutaneous reactions induced by cytokine-targeted antibodies in dermatology.
METHODS: We performed a systematic review and analysis of published cases of cutaneous paradoxical reactions (PRs) reported in association with tumor necrosis factor α, interleukin (IL) 12/23 (p40), IL-17A/17R, IL-23 (p19), and IL-4Rα inhibitors.
RESULTS: We identified 313 articles reporting 2049 cases of PRs. Tumor necrosis factor α inhibitors resulted in 91.2% (1869/2049) of all cases, followed by IL-17/17R (3.5%), IL-4Rα (2.7%), IL-12/23 (2.4%), and IL-23 (0.01%) inhibitors. Psoriasiform and eczematous eruptions were the most commonly reported, but a wide spectrum of patterns were described. Phenotypically overlapping reaction patterns were common. Time to onset typically ranged from weeks to months but could occur more than a year later. Improvement or resolution upon discontinuation of the inciting drug was common.
CONCLUSIONS: This was a retrospective analysis.
CONCLUSIONS: Familiarity with the clinical features of PRs from cytokine-blocking antibodies may facilitate efficient recognition and management.
摘要：
背景:抑制促炎细胞因子信号传导的基于抗体的疗法通常用于皮肤病学。矛盾的是,这些药物可能诱发或加剧炎症性疾病。
目的：总结各种表现，发病率,定时,潜在的机制，以及皮肤病学中细胞因子靶向抗体诱导的反常皮肤反应的一般管理方法。
方法：我们对已发表的与肿瘤坏死因子α相关的皮肤反常反应（PRs）病例进行了系统回顾和分析，白细胞介素（IL）12/23（p40），IL-17A/17R,IL-23（p19），和IL-4Rα抑制剂。
结果：我们确定了313篇报告2049例PR的文章。肿瘤坏死因子α抑制剂导致所有病例的91.2%(1869/2049)，其次是IL-17/17R（3.5％），IL-4Rα（2.7%），IL-12/23（2.4%），和IL-23(0.01%)抑制剂。Psoriasiform和湿疹喷发是最常见的报道，但是描述了各种各样的模式。表型重叠的反应模式是常见的。发病时间通常为数周至数月，但可能在一年后发生。停止煽动药物后的改善或解决是常见的。
结论：这是一项回顾性分析。
结论：熟悉来自细胞因子阻断抗体的PRs的临床特征可能有助于有效的识别和管理。
目的：总结各种表现，发病率,定时,潜在的机制，以及皮肤病学中细胞因子靶向抗体诱导的反常皮肤反应的一般管理方法。
方法：我们对已发表的与肿瘤坏死因子α相关的皮肤反常反应（PRs）病例进行了系统回顾和分析，白细胞介素（IL）12/23（p40），IL-17A/17R,IL-23（p19），和IL-4Rα抑制剂。
结果：我们确定了313篇报告2049例PR的文章。肿瘤坏死因子α抑制剂导致所有病例的91.2%(1869/2049)，其次是IL-17/17R（3.5％），IL-4Rα（2.7%），IL-12/23（2.4%），和IL-23(0.01%)抑制剂。Psoriasiform和湿疹喷发是最常见的报道，但是描述了各种各样的模式。表型重叠的反应模式是常见的。发病时间通常为数周至数月，但可能在一年后发生。停止煽动药物后的改善或解决是常见的。
结论：这是一项回顾性分析。
结论：熟悉来自细胞因子阻断抗体的PRs的临床特征可能有助于有效的识别和管理。
