ArticleNature communications2018
TNF blockade induces a dysregulated type I interferon response without autoimmunity in paradoxical psoriasis.
Article in Nature communications, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03629379 (Response to Ustekinumab for Anti-tnf Induced Psoriasiform Skin Lesions), which is not on this map. Cited by 130 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Response to Ustekinumab for Anti-tnf Induced Psoriasiform Skin Lesions
Who cites it
130 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Vitiligo onset following anti-inflammatory biological therapy: a scoping review.Frontiers in immunology · 2026Pooled it
- Biologic-Induced Paradoxical Psoriatic Alopecia: A Systematic Review.The Australasian journal of dermatology · 2025Pooled it
- Paradoxical psoriasis induced by IL-17 inhibitors: a case series of patients with axial spondyloarthritis and a systematic literature review.Rheumatology international · 2024Pooled it
- The molecular mechanism of the adverse effects of the biological and small molecular drugs in the therapy of inflammatory skin diseases - psoriasis and atopic dermatitis.Annals of medicine · 2026Review
- Immune shifts in inflammatory skin diseases.JID innovations : skin science from molecules to population health · 2026Review
- Paradoxical psoriasis in axial spondyloarthritis and rheumatoid arthritis treated with b/tsDMARDs: a retrospective cohort study.Clinical rheumatology · 2026Article
- Targeting epithelial IFN-I signaling restores barrier integrity in anti-TNF refractory Crohn's disease.Journal of Crohn's & colitis · 2026Article
- PAPASH-like disease associated with a heterozygous NLRP1 variant complicated by papulopustular folliculitis.JAAD case reports · 2026Article
- De novo Generalized Pustular Psoriasis: A Tofacitinib-Induced Paradoxical Adverse Event.Indian dermatology online journal · 2026Article
- Current landscape of drug induced retinal vasculitis.Journal of ophthalmic inflammation and infection · 2026Review
- Kidney pathology findings in pediatric patients with kidney injury and inflammatory bowel disease: a case series.Pediatric nephrology (Berlin, Germany) · 2026Article
- Cutaneous Manifestations in Psoriatic Arthritis: Phenotypes, Clinical Burden, and Therapeutic Implications.Rheumatology and therapy · 2026Review
- Cutaneous Adverse Reactions to IL-17 and IL-23 Inhibitors: A Clinical Review of Reaction Patterns.Dermatology practical & conceptual · 2026Review
- Risk of Incident Immune-Mediated Inflammatory Diseases with Second Tumor Necrosis Factor Inhibitor Versus Alternative Biologic Therapy in Patients with Inflammatory Bowel Disease and First TNFi Exposure: A Real-World Cohort Study.Digestive diseases and sciences · 2026Article
- Palmoplantar pustulosis: pathogenesis, differential diagnosis, and treatment.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2026Review
- Dual-Site Inflammation During Adalimumab Therapy: Birdshot Chorioretinopathy Complicated by Paradoxical Psoriasis.Cureus · 2026Article
- Dermatology 2.0: Precision medicine for inflammatory skin diseases.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026Review
- Paradoxical psoriasis in pediatric tumor necrosis factor-α inhibitor therapy database.Pediatric research · 2026Article
- Article
- Disproportionality analysis highlights paradoxical psoriasis as a clinically significant class effect of tumor necrosis-α inhibitors in pediatric populations.Pediatric research · 2026Article
70 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although anti-tumor necrosis factor (TNF) agents are highly effective in the treatment of psoriasis, 2-5% of treated patients develop psoriasis-like skin lesions called paradoxical psoriasis. The pathogenesis of this side effect and its distinction from classical psoriasis remain unknown. Here we show that skin lesions from patients with paradoxical psoriasis are characterized by a selective overexpression of type I interferons, dermal accumulation of plasmacytoid dendritic cells (pDC), and reduced T-cell numbers, when compared to classical psoriasis. Anti-TNF treatment prolongs type I interferon production by pDCs through inhibition of their maturation. The resulting type I interferon overexpression is responsible for the skin phenotype of paradoxical psoriasis, which, unlike classical psoriasis, is independent of T cells. These findings indicate that paradoxical psoriasis represents an ongoing overactive innate inflammatory process, driven by pDC-derived type I interferon that does not lead to T-cell autoimmunity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.