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Resumen
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by progressive joint damage driven by ongoing inflammation. The introduction of innovative therapies, including biological drugs, has significantly improved patients' quality of life by reducing the severity of joint destruction and slowing disease progression. Some patients undergoing biological therapy may experience adverse effects, including local skin reactions at the injection site and, much more rarely, generalized changes such as de novo psoriasis and other paradoxical skin reactions. This paper describes 2 cases of female patients with a long history of RA (68 and 73 years old), in whom administration of TNF-α inhibitors (Certolizumab pegol in the first, Etanercept in the second) led to allergic urticaria and paradoxical psoriasis. After discontinuation of these drugs, gradual symptom resolution was observed, allowing for alternative treatment with Tocilizumab – a drug from the IL-6 inhibitor group. Reduction of disease symptoms and regression of skin symptoms were achieved. According to literature data, using a drug with the same mechanism of action in the next line of therapy would be associated with a higher risk of psoriasis recurrence. The presented cases emphasize the need for careful monitoring of adverse effects of drugs used in biological therapy, especially regarding the induction of skin complications, not only local but also generalized.
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Derechos de autor 2025 Review of Medical Practice