Treatment with antitumor necrosis factor-alpha (anti-TNF-α) offers a significant 
improvement in several immune-based diseases, including Crohn's disease (CD) and 
psoriasis. Different cutaneous side effects have been described for anti-TNF-α 
therapy such as psoriasis. Previous reports showed that inhibition of TNF-α can 
induce over expression of cutaneous IFN-α, which in turn caused a predisposition 
to psoriasis. We report a 31-year-old woman with extensive CD and perianal 
lesions, without response to conventional treatment. She paradoxically developed 
a cutaneous eruption with psoriasiform morphology and distribution during 
treatment with both anti-TNF-α approved in Europe for CD, infliximab and 
adalimumab. These lesions cleared after topical application of corticosteroids 
and cessation of the anti-TNF-α treatment. Due to uneffectiveness of 
pharmacological treatment on disease, the patient had to undergo surgery. 
TNF-induced psoriasis in patients with CD is rare and has been previously 
documented with infliximab or adalimumab. The reason for this apparently 
paradoxical effect of the therapy is still unclear. This is the first case of 
psoriasis induced first by infliximab and later by adalimumab in the same CD 
patient. We would like to review and to draw attention about psoriasis as a 
cutaneous side effect with anti-TNF-α treatments.