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TNF-α plays an important role in immune defense against Mycobacterium tuberculosis and, as such, the risk of reactivation of latent tuberculosis increases with the TNF-blocking agents. Aims: To determine the prevalence of latent tuberculosis in psoriasis patients undergoing TNF-blocking agents, between 2006 and 2009. Assess the established therapy and their complications. Materials and methods: Review of clinical records and registration of clinical and epidemiological data. The used screening tests were Tuberculin Skin Test, chest x-ray and, in the QuantiFERON®-TB Gold test. Results: Forty-five patients were included in this retrospective study; twenty-seven (60%) had arthritic psoriasis and 18(40%) plaque psoriasis. Only 11% had known epidemiological risk factor for tuberculosis. Tuberculin skin test and chest x-ray were executed in all cases and QuantiFERON®-TB Gold test in four. Latent tuberculosis was confirmed in 18(40%) patients, 16(89%) man and two (11%) women. All of them were treated with isoniazid for nine months. Transient elevation of liver transaminases (mild hepatotoxicity) occurred in four (22%), however no patient developed moderate to severe hepatotoxicity. The entire completed the isoniazid regimen. The average period between the initia- tion of isoniazid therapy and TNF-blocking agent was two months. Mostly (46.7%) received adalimumab. No patients developed active tuberculosis. Conclusion: Latent tuberculosis was diagnosed in 40% of psoriasis patients. All patients completed the isoniazid regi men therapy without relevant complications. No case of active tuberculosis was diagnosed. KEYWORDS – Tumor Necrosis Factor-alpha; Psoriasis; Latent Tuberculosis; Biological Therapy.

revista da sociedade portuguesa de dermatologia e venereologia

DIAGNÓSTICO E TRATAMENTO DA TUBERCULOSE LATENTE EM DOENTES COM PSORÍASE SUBMETIDOS A TERAPÊUTICA COM ANTAGONISTAS DO FACTOR DE NECROSE TUMORAL ALFA – ESTUDO RETROSPECTIVO DE 4 ANOS NO HOSPITAL DE SANTARÉM (PORTUGAL)