Patients with inflammatory bowel diseases (IBD) often present with skin eruptions, which may be associated with therapies and frequently lead to dermatological consults and treatment interruptions. A recent study assessed the impact of joint shared decision-making in a multidisciplinary (MDT) IBD-DERMA clinic.

A consecutive group of patients with IBD who were referred for consultation in an MDT clinic at a tertiary referral center were included in this study. 

The observations were as follows:

• 118 patients were followed-up for 1 year and evaluated.
• 57.6% of the participants were males; the mean age was 35.2 ± 13.5 years, disease duration was 7.1 years, and Crohn’s disease was present in 79.6% of the individuals.
• The commonest diagnosis was skin eruption induced by an anti-tumor necrosis factor (TNF) (39%), which included psoriasiform dermatitis (PD) (67.4%) and inflammatory alopecia (IA) (32.6%).
• Of these, 39.1% continued the anti-TNF agent along with a topical or systemic anti-inflammatory agent to arrest the eruption, while the remaining 60.9% discontinued the anti-TNF, of whom 57.1% changed to ustekinumab.
• These strategies treated the majority (82.6%) of patients effectively.
• Continuation of the anti-TNF was feasible in a significantly higher proportion of patients with PD (38.7%) than only one in the IA group.
• IA group showed a higher switch (46.6%) to ustekinumab than the PD (22.6%) group.
• Following IBD-DERMA advised intervention, IBD deteriorated in 19.5% of patients, with 55.56% on ustekinumab.

Thus shared decision-making in an integrated IBD-DERMA clinic showed good control of skin eruptions while preserving control of the underlying IBD in more than 80% of cases. Patients with IA benefited from a switch to ustekinumab.

Source: Yanai H, Amir Barak H, Ollech JE, et al. Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic. Therap Adv Gastroenterol. 2021;14:17562848211053112.