ArticleFrontiers in immunology2026
Case Report: Paradoxical psoriasis under TNF-α blockade may represent generalized abscessing staphyloderma - GASD syndrome by TNF antagonists.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Patients treated with TNF-α antagonists may develop psoriasis-like skin lesions. Clinical manifestations include palmoplantar, inverse, localized or generalized guttate, plaque-type, eczematous, and pustular lesions; deep inflammatory nodes; and nonscarring alopecia, often with overlapping reaction patterns. They are classified as paradoxical psoriasis and interpreted as an inflammatory reaction resulting from the disturbed maturation of plasmacytoid dendritic cells, with overproduction of type I interferons due to tumor necrosis factor α (TNF-α) inhibition. Management frequently necessitates discontinuation of therapy. Here, we review the clinical presentation of six patients who were initially diagnosed with paradoxical psoriasis during TNF-α blockade due to the development of corresponding skin lesions. Dermatologic examination revealed that the lesions were impetigo contagiosa, ecthyma, folliculitis decalvans, ostiofolliculitis, nummular microbial eczema, or abscessing furunculosis-all caused by
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