Table 1: Reactive granulomatous dermatitis during anti-TNF therapy: literature review.

Authors, year [Ref] F/M (age) Diagnosis TNFa agent Concurrent treatment Duration of use Type of gronulomatous lesions Location Discontinuation of TNFa Treatment and Outcome
Present case, 2016 M (56) PA ADA MTX 20 m Skin erythematous patches of 20-30 mm of diameter and plaques, infiltrated nodules Cheek, nose, forehead Withdrawal CS and ciprofloxacin, doxycycline, metronidazole - no improvement; HCQ - resolved
Palisaded Neutrophilic and Granulomatous Dermatitis (PNGD)
Bremner, et al. [25]
#1 F (57) RA IFX MTX 3 m Annular papules and plaques Medial thighs, axillary folds, back nr DPS - improved
#2 F (27) RA IFX MTX nr Papules/Vescicles and papules Buttocks, posterior thighs/palms, fingers nr CS DPS HCQ - modest improvement
#3 F (54) RA ETA nr nr Nodules Legs and feet ETN replaced with INF Topical TCR - modest improvement
Deng, et al. [16]
#1 F (48) RA IFX nr Generalized annular nodules and plaques Back and shoulders Withdrawal Improved, lost follow-up
#2 F (65) RA IFX nr Macules and plaques Flank and forearm Withdrawal Resolved
#3 F (34) RA ETA MTX nr Papules Elbows Withdrawal Lesions persistence
Collaris EJ, et al. [22] M (57) RA IFX - 9 m PNGD plaques Nose/extensor elbow No Topical metronidazole resolved/topical CS resolved
Stephenson SR, et al. [13] F (56) RA ADA MTX, CS 24 m PNGD patches and plaques Legs Withdrawal AZA, CS - cleared
Umezawa Y, et al. [26] F (64) RA ADA CS 10 m PNGD papules erythema, purpura Hands, plantae Withdrawal Topical CS - cleared after ADA discontinuation
de Unamuno Bustos B, et al. [27] F (41) AS/RA ETA/ADA - 18 m/8 m PNGD erythematous papules Forearms and elbows/fingers Withdrawal Topical CS resolved/persistence in TCZ
Interstitial Granulomatous Dermatitis (IGD)
Patsatsi, et al. [28] F (70) RA ADA - 1 m after withdrawal IGD papules Umbilicus Withdrawal and re-initiation Non response to topical CS, resumed ADA
Guerin, et al. [29] F (61) RA ADA 7 m IGD plaques Lower extremities Withdrawal CS, LFM - resolved
Interstitial Granulomatous Drug Reaction (IGDR)
Martorell, et al. [30] F (45) PA ADA 6 m Nodules Legs Withdrawal Cleared

Legend: F: Female; M: Male; RA: Rheumatoid Arthtritis; AS: Axial Spondyloarthritis; PA: Psoriatic Arthritis; PNGD: Palisaded Neutrophilic and Granulomatous Dermatitis; IGD: Interstitial Granulomatous Dermatitis; IFX: Infliximab; ADA: Adalimumab; ETA: Etanercept; MTX: Methotrexate; CS: Corticosteroids; nr: not recorded; DPS: Dapsone; HCQ: Hydroxychloroquine; TCR: Tacrolimus; AZA: Azathioprine; TCZ: Tocilizumab; LFM: Leflunomide.