Atypical Cutaneous Tuberculosis in a Patient with Rheumatoid Arthritis Treated with Infliximab

Sir, Anti-tumour necrosis factor alpha (TNF-α) agents, such as infliximab, adalimumab and etanercept, are remarkably effective in the treatment of rheumatoid arthritis (RA), Crohn's disease and psoriasis vulgaris (1–4). Recent case reports have described the treatment of hidradenitis suppurativa (5) and acne conglobata (6) with infliximab. Regardless of the dramatic improvement in symptoms, it has been documented that various infections, such as tuberculosis, pneumocystis and aspergillosis, often develop among patients treated with these agents (7). We report here a patient with RA who developed atypical cutaneous tuberculosis following the administration of infliximab.