Biologic therapy and tuberculosis: our experience and review of literature

Abstract

Caterina Fabroni,1 Angelo Massimiliano D’Erme,2 Torello Lotti3 1Department of Dermatology, Misericordia e Dolce Hospital, Prato, Italy; 2Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy; 3Guglielmo Marconi University, Rome, Italy Abstract: Psoriasis is an inflammatory dermatologic disease that can often involve not only the skin and mucosal surfaces but also the bones and joints. It affects approximately 3% of the world’s population, and has a chronic-relapsing course. The management of psoriasis is often difficult and, particularly in the case of moderate to severe forms, the use of systemic therapies is mandatory. The introduction of biologic drugs has greatly improved our ability to treat psoriasis. However, it is necessary to underline that antitumor necrosis factor-α treatments may reactivate latent tuberculosis infection and cause particularly disseminated or extrapulmonary disease. Physicians should carry out proper screening of patients before starting treatment with antitumor necrosis factor-α, in order to identify individuals with latent tuberculosis infection. We report our experience in this field and review the various existing tests to screen for tuberculosis. Keywords: infliximab, adalimumab, tuberculosis, psoriasis