Psoriasiform　skin　lesion　induced　by　tumor　necrosis　factor　inhibitors　in　a　patient　with　juvenile　idiopathic　arthritis．

Abstract

A20-year-old　woman　with　undifferentiated　arthritis　juvenile　idiopathic　arthritis（JIA）developed　a　red excoriated　plantar　skin　lesion　at　the　age　of　19 years．　She　was　diagnosed　with　JIA　at　the　age　of　l5　years．　Her disease　was　controlled　with　the　treatment　of　methotrexate　and　etanercept（ETA）．　Skin　biopsy　of　plantar　skin lesion　revealed　a　psoriasiform　hyperplasia　in　the　epidermis．　The　diagnosis　of　psoriasiform　skin　lesion　induced by　ETA　was　made．　There　was　no　improvement　with　topical　antibiotics　and　steroids．　Because　of　severe　skin lesions，ETA　was　discontinued　and　tocilizumab　therapy　was　started．　The　skin　lesions　had　resolved　six　months later．　Psoriasifbrm　skin　lesions　induced　by　TNF-α antagonists　are　rare，but　pediatricians　should　remain　aware of the　possibility　of psoriasis　arising　in　JIA　patients　treated　with　TNF-α antagonists．