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Review
. 2020 Nov;33(6):e14207.
doi: 10.1111/dth.14207. Epub 2020 Sep 7.

Interstitial granulomatous dermatitis following tocilizumab, a paradoxical reaction?

Arcadi Altemir  1 , Maribel Iglesias-Sancho  1 , María de Los Ángeles Sola-Casas  1 , Luis Novoa-Lamazares  1 , Maite Fernández-Figueras  2 , Montse Salleras-Redonnet  1
Affiliations
Review

Interstitial granulomatous dermatitis following tocilizumab, a paradoxical reaction?

Arcadi Altemir et al. Dermatol Ther. 2020 Nov.

Abstract

Interstitial granulomatous dermatitis (IGD) is a rare dermatosis generally seen in the setting of rheumatic diseases, but also hematological disorders, internal malignances, infections, or drug induced. Herein, we report an exceptional case of an IGD with a clear chronological association with tocilizumab onset and cessation in a patient with adult-onset Still's disease. We review the granulomatous cutaneous reactions so far reported with this novel therapy: sarcoidosis, granuloma annulare, and IGD. Tocilizumab is a humanized anti-interleukin 6 receptor monoclonal antibody useful for the treatment of various systemic inflammatory disorders. Lately, it has found useful also for granulomatous diseases such as giant cell arteritis and even a promising response in IGD. Therefore, we believe our case adds the possibility of an IGD presenting as a paradoxical reaction.

Keywords: granulomatous drug reaction; interleukin-6 inhibitors; interstitial granulomatous dermatitis; paradoxical reaction; tocilizumab.

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References

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