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Peer Reviewed

DermClinic

What Caused Her Psoriasis?

David L. Kaplan, MD—Series Editor

Volume 53 - Issue 10 - October 2013

 

  • ANSWER—Herpes zoster

    This patient was given valcyclovir 1 g tid for 1 week. She was instructed to withhold her dose of etanercept for the week. She has resolution of the herpes zoster without any significant post herpetic neuralgia. 

    psoriasis

    Note: 166,330 people have reported side effects to FDA from Enbrel, 106 have post-herpetic neuralgia since 2005, 57% have been on Enbrel less than six months, and 95% had been on Enbrel less than two years. This data would suggest that individuals over the age of 50 on etanercept in the first years should be monitored for herpes zoster; however, the risk for post-herpetic neuralgia is uncertain as it is unknown if the incidence noted above is any greater than would expected. ■

    Reference

    Di Costanzo L, Ayala F, Megna M, et al. The risk of herpes zoster in the anti-TNF-α era: a case report and review of the literature. J Dermatol Case Rep. 2013;7(1):1-4.