Treatment of psoriatic arthritis with antitumour necrosis factor-alpha antibody clears skin lesions of psoriasis resistant to treatment with methotrexate

Background In inflamed skin, keratinocytes and inflammatory cells both prod uce large amounts of tumour necrosis factor (TNF) -alpha, a cytokine with b road effects that are relevant to inflammation. Blockade of this proinflamm atory cytokine by a monoclonal anti-TNF-alpha antibody might be effectively used in the treatment of inflammatory skin diseases. Objectives To gather information about the efficacy of an anti-TNF-alpha an tibody (infliximab) in the treatment of skin lesions of psoriatic arthritis . Methods Six patients with progressive joint disease and psoriatic skin lesi ons unresponsive to methotrexate therapy were treated with anti-TNF-alpha a ntibody. The Psoriasis Area and Severity Index was determined before and 10 weeks after initiation of therapy. Results Improvement of psoriatic skin lesions was observed in all patients. In addition, a marked improvement of the joint disease was noted. Conclusions Therapy with anti-TNF-alpha antibody may be an effective treatm ent regimen for both psoriatic arthritis and psoriatic skin lesions.