Paradoxical cutaneous reactions associated with tocilizumab therapy

Introduction. - Tocilizumab (TCZ) is a humanized antihuman interleukin (IL)-6 receptor antibody recommended for the treatment of moderate to severe active rheumatoid arthritis, adult-onset Still disease, Castleman disease and more recently, systemic juvenile idiopathic arthritis. Like anti-TNF alpha, rituximab and less frequently abatacept, TCZ can induce paradoxical cutaneous eruption like psoriasis with predominantly palmoplantar presentation. Case report. - We report a 47-year-old woman with psoriastic arthritis who developed under anti-TNF alpha therapy and later under tocilizumab a paradoxical palmoplantar eruption. Conclusion. - The specific underlying mechanisms of this side effect are unclear but relapse of these lesions seems to be observed with certain biological agents. (C) 2014 Societe nationale francaise de medecine interne (SNFMI). Publie par Elsevier Masson SAS. Tous droits reserves.