[Psoriasiform skin reactions during treatment with etanercept].

Anti-TNFs have a wide spectrum of skin lesions, psoriasis being found among them paradoxically. A 42-year old woman with a history of rheumatoid arthritis since 19 years of age was referred to the Dermatology service due to pustular psoriasis on both soles during treatment with etanercept. Due to her incapacity to walk and the pain reported by the patient, etanercept was replaced with adalimumab with clinical improvement and total disappearance of the lesions at six weeks of switching the anti-TNF. Tumor necrosis factor inhibitors are drugs that act in T cell mediated diseases. The appearance of psoriasiform rashes is more frequent than reported in the literature. They appear in all the indications and with all the anti-TNFs. Adalimumab is the most frequent. Three types of reactions are produced, the pustular one being the most frequent. It predominates in women and may appear chronologically at any time during the treatment. Regarding the treatment, it is recommendable to continue with the anti-TNFs.