Cutaneous Manifestations of Reactions to Biologics

Abstract

Purpose of review: The goal of this paper is to review the major adverse cutaneous reactions that have been reported to the most commonly used biologics.

Recent findings: Anti-TNF agents and immune checkpoint inhibitors have significant, immune-mediated cutaneous manifestations that can necessitate discontinuation. Anti-TNF agents, IL-6 inhibitors, and IL-12/23 inhibitors can paradoxically cause psoriasis flares or unmask previously undiagnosed psoriasis. IL-17 inhibitors are unique in increasing risk for Candida infections. Benign injection site reactions, non-specific rash, cellulitis, and hypersensitivity reactions are relatively common adverse events. A wide variety of cutaneous reactions caused by biologics have been reported, ranging from benign injection site reactions to life-threatening cutaneous reactions necessitating discontinuation of the implicated biologic agent.

Keywords: Anti-TNF agents; Biological therapies; Biologics; Cutaneous reactions; IL-12/23 inhibitors; IL-6 inhibitors.