Table 2.
Drug | Adverse events | Prevalence/comments |
---|---|---|
Thiopurines | Skin and soft tissue infection Non-melanoma skin cancer Drug hypersensitivity Shingles |
Frequently cellulitis Patient education, sun protection, and routine annual skin check important Prevalence up to 10%377 Patients aged > 60 years treated in combination with systemic corticosteroids are at higher risk 378,379 |
Anti TNF | Skin reactions Drug-induced lupus erythematosus [DILE] Skin and soft-tissue infection Melanoma Paradoxical skin reactions: eczema-like, psoriasis-like |
Subcutaneous injection site reaction and delayed infusion reaction 380
Rare; no class effect 381 Cellulitis, erysipelas, abscess [0.1% to 7%] 382,383 Slight increased risk 382,383,384 Psoriasis: pustular phenotype [commonly palms and soles]; eczema: atopic diathesis 385,386 |
Sulfasalazine | Exfoliative dermatitis, StevensJohnson syndrome, and toxic epidermal necrolysis | Rare but serious skin reactions, some fatal; discontinue drug if skin or mucosal lesion387 |
Methotrexate | Alopecia Generalised skin rash Oral and intertriginous lesions |
< 10%; more common long term Less frequent than reported Rare; consider drug over-dosage [daily instead of weekly]388 |
Vedolizumab | Infusion-related and hypersensitivity reactions Rash, pruritus, eczema, acne |
Requires previous antihistamine, hydrocortisone. and/ or paracetamol389 |