Open AccessMycobacterium Kansasii infection in a psoriasis patient treated with adalimumab and switch to apremilast: first report and literature review
Author(s) -
Alexandra Maria Giovanna Brunasso,
Sanja Javor,
Emanuele Pontali,
Simona Sola,
Cesare Massone
Publication year - 2021
Publication title -
dermatology reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.183
H-Index - 10
eISSN - 2036-7406
pISSN - 2036-7392
DOI - 10.4081/dr.2021.8797
Subject(s) - medicine , adalimumab , mycobacterium kansasii , dermatology , tuberculosis , psoriasis , quantiferon , infliximab , asymptomatic , mycobacterium tuberculosis , pathology , disease , latent tuberculosis
Patient under anti-TNF-alpha treatment have an increased risk of mycobacterial infections, particularly tuberculosis. Only four case reports of Mycobacterium kansasii infection under anti-TNF-α treatment (two with etanercept, two with infliximab) have been reported, but none under adalimumab. A 72-year-old man treated with adalimumab for psoriasis vulgaris and arthropathic psoriasis, complained on nocturnal cough, occasional hemoptysis and the new onset of ill-defined, reddish, asymptomatic persistent plaquesnodules covered by serum crusts on his back, on the dorsum of the right hand and right middle finger. Routine laboratory investigations, HIV and TB screening (QuantiFERONTB- Gold test) were all within normal limits. A skin biopsy was inconclusive and special stainings resulted negative for microorganisms. Only PCR identified M. kansasii. The patient stopped adalimumab and started anti-TB treatment with gradual improvement of the skin lesions. At 26 months follow-up visit no signs or symptoms of relapse of M. kansasii disease occurred.