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    Journal of Pharmacology and PharmacotherapeuticsNOW IN
    Article

    A case of figurate urticaria by etanercept

    Maurizio Sessa1, Maria Giuseppa Sullo1★, Annamaria Mascolo1, Daniela Cimmaruta1, Francesca Romano2, Rosa Valentina Puca2, Annalisa Capuano1, Francesco Rossi1, Ada Lo Schiavo2★ Corresponding author

    1. 1Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Section of Pharmacology, Second University of Naples, Via Costantinopoli 16, 80138 Naples, Italy.
    2. 2Department of Dermatology, Second University of Naples, Naples, Italy.

    CORRESPONDENCE

    Maria Giuseppa Sullo

    Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Section of Pharmacology, Second University of Naples, Via Costantinopoli 16, 80138 Naples, Italy.

    mariagiuseppa.sullo@unina2.it

    Received: 04-12-2015; Revised: 07-01-2016; Accepted: 26-03-2016.

    Volume 7, Issue 2 · pp. 106–108 · PUBLISHED 2016 · DOI: 10.4103/0976-500X.184777

    View on J Pharmacol. Pharmacother. original site ↗

    ABSTRACT

    Etanercept is a competitive inhibitor of tumor necrosis factor‑alpha (TNF‑α) a polypeptide hormone, involved in the development of the immune system, in host defense and immune surveillance. Even if the etanercept mechanism of action is not completely understood, it is supposed that it negatively modulates biological responses mediated by molecules (cytokines, adhesion molecules, or proteinases) induced or regulated by TNF. For this reason, it is widely used in the treatment of immunologicals diseases, such as rheumatoid and psoriatic arthritis, polyarticular juvenile idiopathic active, ankylosing spondylitis, and plaque psoriasis. Etanercept has a good tolerability profile. Adverse events related to skin are rare, arising usually in about 5% of patients treated with anti‑TNF α. In this scenario, we describe a case of figurate urticaria arose after the re‑administration of etanercept in a patient affected by psoriasis and hepatitis B. A 65‑year‑old man, affected by psoriasis, was hospitalized in September 2014 to the Regional Center for the treatment of psoriasis and Biological Drugs of Second University of Naples for progressive extension of psoriatic skin lesions. The laboratory analysis detected positivity for hepatitis B virus (HBV) antigens. For this reason, it was administered to him lamivudine 100 mg/die about 30 days before to start etanercept treatment. The etanercept therapy has resulted in a progressive improving of skin manifestations, and the patient decided individually to stop the therapy. Afterwards, for worsening of the psoriatic lesions, he was again hospitalized and treated with the same therapeutic schedule (lamivudine followed by etanercept). Ten days after the start of therapy, the patient showed the onset of urticarial rash. Due to this, the treatment with lamivudine and etanercept was suspended and the patient’s clinical conditions improved. It is probably that immunological disorders due to etanercept therapy and HBV infection could explain the onset of figurate urticaria in our patient. In this contest, the post‑marketing surveillance confirms its important role in the monitoring of drugs tolerability and effectiveness.

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      Sessa, M., Sullo, M. G., Mascolo, A., Cimmaruta, D., Romano, F., Puca, R. V., Capuano, A., Rossi, F., & Schiavo, A. L. (2016). A case of figurate urticaria by etanercept. Journal of Pharmacology and Pharmacotherapeutics, 7(2), 106–108. https://doi.org/10.4103/0976-500X.184777