Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 8: My Patient On Tumor Necrosis Factor Alpha Therapy Has A Rash. What Should I Do? (continued)

Abrar A. Qureshi, MD; Andrew C. Walls, MD

While they have generally proven well tolerated, the tumor necrosis factor (TNF) inhibitors have a broad range of cutaneous adverse effects that range from minor injection-site reactions to potentially fatal total-body desquamation. We will attempt to provide clues for diagnosis, as well as steps for initial management and decision criteria for seeking help from colleagues via referral. Table 8-1 and Figure 8-1 provide an overview of potential cutaneous reactions and demonstrate the broad differential diagnosis and approach to evaluation for these reactions. The first step in determining the…