Wafa Hamdi, Saoussen Miladi, Dhia Kaffel, Imene Zouch and Montacer Mohamed Kchir
Biological disease modifying anti-rheumatic drugs (bDMARDs) have improved outcome of rheumatoid arthritis (RA). Tocilizumab (TCZ) is a monoclonal humanized anti-interleukin-6 receptor (IL6-R) which is indicated in case of inadequate response to one or more DMARDs or other biological treatment. Vasculitis has been reported with anti- TNF (Tumor Necrosis Factor) agents among more than 140 cases according to the BIOGEAS study group ( a Study Group on Autoimmune Diseases of the Spanish Society of Internal Medicine) but only in two cases with TCZ. We report the first case of cutaneous vasculitis occurring under both anti-TNF therapy and TCZ.
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