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First Reported Mycobacterium Marinum Infection Case in a Patient With Psoriatic Arthritis Maintained on Golimumab
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First Reported Mycobacterium Marinum Infection Case in a Patient With Psoriatic Arthritis Maintained on Golimumab
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Journal Article
First Reported Mycobacterium Marinum Infection Case in a Patient With Psoriatic Arthritis Maintained on Golimumab
2020
Overview
Tumor necrosis factor (TNF) inhibition has become a widely used biological therapy in patients with underlying autoimmune diseases and its association with increased risk for tuberculosis and other granulomatous diseases has been extensively studied recently.1 Non-tuberculous mycobacterial infections are also associated with the immune dysfunction caused by the use of immunomosdulatory drugs, mainly anti TNF-alpha (a), ranging from localized skin infection to disseminated disease.2,3 Psoriasis and psoriatic arthritis patients treated with anti-TNF are at higher risk of developing skin non-tuberculous mycobacterial infection due to the disease itself and the combined side effect of the medications used.4 The following case describes a skin infection with Mycobacterium marinum (M. marinum) associated with the use of golimumab, a fully human monoclonal antibody against TNF-a, in a patient with psoriatic arthritis. A 53-year-old female patient with psoriatic arthritis followed at the rheumatology-dermatology clinic presented for evaluation of a non-resolving indurated plaque over the base of the right fifth digit despite the use of local steroid and systemic treatment for her arthritis. Mycobacterium marinum is an atypical mycobacteria or mycobacteria other than Mycobacterium tuberculosis that is typically associated with fishes and water.5 Few cases of M. marinum infection were reported in patients treated with anti-TNF-a ranging from localized skin infection to disseminated disease.2,3 The literature mentions only six cases of psoriasis associated with M. marinum infection and anti-TNF-a was administered in all cases.4,6-9 This is another rare case of M. marinum sporotrichoid-like skin infection in a patient on anti-TNF-a treatment.
Publisher
Prof Sebnem Ataman, President Turkish League Against Rheumatism
Subject
