P578 Therapeutic strategies in the approach of paradoxical psoriasis in IBD: experience of a centre
S. Santos*1, V. Gamelas2, D. Carvalho2, C. Bernardes2, J. Saiote2, J. Ramos2
1Centro Hospitalar Lisboa Central EPE, Gastroenterology, Lisboa, Portugal, 2Centro Hospitalar Lisboa Central, Lisboa, Portugal
Induction of psoriasis with the use of TNFα antagonists, also used in its treatment, is a phenomenon described in inflammatory bowel disease. We intended to analyse predictive factors for the development of this entity and results of the different strategies in its treatment.
Analysis of a cohort under treatment with anti-TNFα between 2005 and 2018. Patients who developed paradoxical psoriasis following onset of anti-TNFα, confirmed by Dermatology were compared with the group without occurrence of cutaneous lesions with treatment. Statistical analysis was performed using SPSS.
291 patients were treated with anti-TNFα, of which 18 (6.2%) developed paradoxical psoriasis. Of these, 13 (72%) were female, with a mean age of 36 years. The majority were under infliximab (
In this cohort the development of paradoxical psoriasis in inflammatory bowel disease under anti-TNFα was 6.2%, with a higher prevalence in females and in the presence of extraintestinal manifestations. Definitive anti-TNFα suspension was required in 7 patients (38.8%) and the swap strategy was effective in most cases.