Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2013 Feb;115(2):e36-40.
doi: 10.1016/j.oooo.2012.08.001. Epub 2012 Oct 1.

Erythema multiforme major following treatment with infliximab

Dean Edwards  1 , Eli Boritz, Edward W Cowen, Ronald S Brown
Affiliations
Case Reports

Erythema multiforme major following treatment with infliximab

Dean Edwards et al. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Feb.

Abstract

Background: The growth in the use of anti-tumor necrosis factor α (TNF-α) agents for treatment of inflammatory conditions has led to increased recognition of the side effects associated with this class of drugs.

Case description: We report a case of a patient who developed erythema multiforme (EM) major with characteristic oral and cutaneous lesions following treatment with the anti-TNF-α medication infliximab therapy for Crohn's disease (CD).

Clinical implications: To our knowledge, this is the first reported case of infliximab-induced EM secondary to the treatment of CD. It is important for dental clinicians evaluating patients using anti-TNF-α agents to be aware of this possible complication.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Clinical oral presentation includes (A, B, C) shallow ulcerations with an erythematous halo and pseudomembrane on the labial mucosa, and larger (1 cm) ulcerations on the tongue. (D) H&E staining of the upper labial mucosa reveals prevalent lymphocytic infiltrate and necrotic keratinocytes. Labial biopsy section shown at 10× magnification. (E,F,G) Results post-treatment with dexamethasone (0.5 mg/5 ml) oral rinse.
Figure 2
Figure 2
(A–E) Dermal presentation of the hands and forearm consisted of multiple small erythematous papules that had a central dusky appearance.
See this image and copyright information in PMC

References

    1. Kvien TK, Heiberg LE, Kaufmann C, Mikkelsen K, Nordvag BY, Rodevand E. A Norwegian DMARD register: prescriptions of DMARDs and biological agents to patients with inflammatory rheumatic diseases. Clin Exp Rheumatol. 2005;23:S188–S194. - PubMed
    1. Braun J, Deodhar A, Kijkmans B, Geusens P, et al. Efficacy and safety of infliximab in patients with ankylosing spondylitis over a two-year period. Arthritis Rheum. 2008;59:1270–1278. - PubMed
    1. Fidder HF, Schnitzier F, Ferrante M, Norman M, et al. Long-term safety of infliximab for the treatment of inflammatory bowel disease: a single-centre cohort study. Gut. 2009;58:501–508. - PubMed
    1. Zabana YE, Domenech E, Manosa M, Garcia-Planella E, et al. Infliximab safety profile and long-term applicability in inflammatory bowel disease: 9-year experience in clinical practice. Aliment Pharmacol Ther. 2010;31:553–560. - PubMed
    1. Colombel JF, Loftus EV, Jr, Tremaine WJ, Egan LJ, et al. The safety profile of infliximab in patients with Crohn's disease: the Mayo clinic experience in 500 patients. Gastroenterology. 126(1):19–31. - PubMed

Publication types