ReviewCureus2023
Paradoxical Tumor Necrosis Factor-Alpha (TNF-α) Inhibitor-Induced Psoriasis: A Systematic Review of Pathogenesis, Clinical Presentation, and Treatment.
Review in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- A systematic review of therapeutic and paradoxical roles of tumor necrosis factor α inhibitors in autoimmune blistering diseases.Inflammopharmacology · 2026Pooled it
- Immunological Activity of Vaccine Systems Containing Liposomal Nanocarriers against Protozoan-induced Diseases: A Systematic Review.Current medicinal chemistry · 2025Pooled it
- Cutaneous Manifestations in Psoriatic Arthritis: Phenotypes, Clinical Burden, and Therapeutic Implications.Rheumatology and therapy · 2026Review
- Variation in the access and use of biologic and targeted synthetic DMARDs in juvenile idiopathic arthritis: insights from a national UK survey.Pediatric rheumatology online journal · 2026Article
- Dual-Site Inflammation During Adalimumab Therapy: Birdshot Chorioretinopathy Complicated by Paradoxical Psoriasis.Cureus · 2026Article
- Effectiveness of Biological Therapy in Psoriasis: Real-World Evaluation of SII and SIRI as Biomarkers of Systemic Inflammation.Dermatology practical & conceptual · 2026Article
- Case Report: Paradoxical psoriasis under TNF-α blockade may represent generalized abscessing staphyloderma - GASD syndrome by TNF antagonists.Frontiers in immunology · 2026Article
- Psoriasis: microbiome dysbiosis and pathogenic mechanisms.Frontiers in immunology · 2026Review
- Role of dendritic cells and B cells in the skin of imiquimod (IMQ)-induced psoriasis-like mouse model.PeerJ · 2026Article
- Brevilin A reverses colitis of inflammatory bowel disease via modulation of TNF-α signaling and microbiome dysregulation.Gut pathogens · 2025Article
- Preparation of Lipid Cubic Liquid Crystalline Nanoparticles of Sinomenine Based on Molecular Dynamics Simulations and Investigation of the Efficacy Against Rheumatoid Arthritis.International journal of molecular sciences · 2025Article
- Moving beyond cytotoxicity in cancer immunotherapy: embracing tumor microenvironment remodeling for durable control.British journal of cancer · 2025Review
- Case Report: Successful treatment of refractory synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome and palmoplantar pustulosis with ustekinumab.Frontiers in immunology · 2025Article
- Infection Risk and Vaccination in the Management of Psoriasis: Considerations for Biologic Therapy.Psoriasis (Auckland, N.Z.) · 2025Review
- An improved understanding of pediatric chronic nonbacterial osteomyelitis pathophysiology informs current and future treatment.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Review
- Research trends and hotspots in biologics for plaque psoriasis: A bibliometric study from 2004 to 2023.Heliyon · 2024Article
- Paradoxical Psoriasis in Patients Receiving Therapy with Tumor Necrosis Factor Inhibitors: Potential Pathogenic Mechanisms and the Role of Genetic Factors.International journal of molecular sciences · 2024Review
- Anti-Psoriatic Activity of Black, Green and White Tea Extracts from Southeastern China.Molecules (Basel, Switzerland) · 2024Article
- Skin barrier-inflammatory pathway is a driver of the psoriasis-atopic dermatitis transition.Frontiers in medicine · 2024Review
- Successful Treatment of Refractory Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome and Paradoxical Psoriasis with Secukinumab: A Case Report.Clinical, cosmetic and investigational dermatology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tumor necrosis factor-alpha (TNF-α) inhibitors have been shown to be well tolerated among patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis. Meanwhile, more recently, clinical practice and research efforts have uncovered increasing cases of psoriatic lesion development tied to initiating treatment with a TNF-α inhibitor. The underlying mechanisms associated with this occurrence have yet to be fully elucidated. A review and analysis of cases of paradoxical psoriasis currently published in the literature is warranted. In addition, exploring possible mechanisms of action and potential treatment options associated with favorable outcomes is much needed. A systematic literature review was performed utilizing PubMed and Google Scholar databases (1992-present), in which 106 cases of paradoxical psoriasis were reviewed. The most common morphology developed was plaque psoriasis vulgaris. There was a female predominance (61.3%), and the most common underlying autoimmune disease was rheumatoid arthritis (45.3%). In addition, the most commonly associated drug with the onset of psoriatic lesions was infliximab (62.3%). Furthermore, the findings suggest that the most well-supported mechanism of action involves the uncontrolled release of interferon-alpha (IFN-α) from plasmacytoid dendritic cells (pDCs) after TNF-α inhibition. While TNF-α inhibitors have been shown to have great benefits to patients with rheumatologic diseases, cases of paradoxical psoriasis demonstrate the importance of close monitoring of patients on TNF-α inhibitors to allow for early recognition, treatment, and potentially change to a different mechanism of action of the medication used to prevent further progression of the inflammatory lesions.
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What OpenQuestion holds
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.