New-Onset Vitiligo Following Etanercept for Ankylosing Spondylitis

Main Article Content

Carly Dunn
Stacy L. McMurray
Allison Jones
Debendra Pattanaik


vitiligo, etanercept, TNF-alpha inhibitors, ankylosing spondylitis, immune-mediated skin disease


Tumor Necrosis Factor-alpha (TNF-a) inhibitors, are used widely to treat a variety of chronic inflammatory conditions such as ankylosing spondylitis, Crohn’s disease, rheumatoid arthritis, and psoriasis. Recently, there has been an increase in the number of reports of immune-mediated skin diseases, such as lichen planus, psoriasis, granuloma annulare, following the initiation of TNF-a inhibitors. We present a patient with ankylosing spondylitis previously treated with adalimumab who developed vitiligo shortly after switching to etanercept to achieve better control of his joint disease.


Exarchou SA, Voulgari DV, Markatseli TE, Zioga A, Drosos AA. Immune-mediated skin lesions in patients treated with anti-tumor necrosis factor alpha inhibitors. Scand J Rheum. 2009;38(5):328-331.

Ismail WA, Al-Enzy SA, Alsurayei SA, Ismail AE. Vitiligo in a patient receiving infliximab for refractory ulcerative colitis. Arab J Gastroenterol. 2011;12(2):109-111. doi:10.1016/j.ajg.2011.03.001.

Carvalho CLDB, Ortigosa LCM. Segmental vitiligo after infliximab use for rheumatoid arthritis – a case report. An Bras Dermatol. 2014;89(1). doi: 10.1590/abd1806-4841.20142887 

Toussirot E, Aubin F. Paradoxical reactions under TNF-α blocking agents and other biological agents given for chronic immune-mediated diseases: An analytical and comprehensive overview. RMD Open. 2016;2(2):1-12. doi:10.1136/rmdopen-2015-000239.

Simon JA, Burgos-Vargas R. Vitiligo improvement in a patient with ankylosing spondylitis treated with infliximab. Case Rep Dermatol. 2008;216:234-235. Doi: 10.1159/000112932

Bae JM, Kim M, Lee HH, et al. Increased Risk of Vitiligo Following Anti-Tumor Necrosis Factor Therapy: A 10-Year Population-Based Cohort Study. J Invest Dermatol. 2018;138(4):768-774. doi:10.1016/j.jid.2017.11.012.

Most read articles by the same author(s)