Introduction

Biological therapy with anti-TNFα agents used in the
treatment of psoriasis as well as other immunologically
mediated pathologies has become a common therapeutic
option that offers certain therapeutic benefits but is not
without adverse reactions. The paradoxical ones are signs
and symptoms that occur during therapy with biological
agents similar to those under the pathological conditions
that constitute an indication for biological therapy. The
overall incidence as well as the etiopathogenic mechanism
underlying these reactions are still unclear.

Material and method

We will present a female patient with psoriasis
vulgaris and seronegative rheumatoid arthritis, who
followed a treatment with an anti-TNFα biological agent
for 3 years, with favourable therapeutic effect until the
recurrence of severe skin lesions and an exacerbated osteoarticular
algic syndrome, manifestations considered in this
context as paradoxical adverse reactionstothe anti-TNFα
therapy.

Discussions and conclusions

Paradoxical adverse reactions (PAR) are rare and
unusual during anti-TNFα therapy and are not limited to
agents in this class. Their management is a challenge, and
prognosis depends on severity and accessibility to
therapeutic alternatives.