Carlos H Colegial, Paula V Gaete
Overlap myositis refers to the simultaneous occurrence of myositis and another systemic autoimmune disease. Association between psoriasis and inflammatory myopathy is uncommon. Tumor necrosis factor (TNF)-alpha antagonists are used to treat patients with psoriasis and arthritis associated with psoriasis. Although the use of TNF-alpha-blocking agents increases the risk of developing myopathy more than 4 times in people with psoriasis, this association is underrecognized. Here, we describe the case of a young male who developed inflammatory myopathy after the use of TNF-alpha blocking therapy for the treatment of psoriasis, associated with cN-1A and NXP2 autoantibodies. After cessation of the TNF-alpha blocking agent and pulse corticosteroid therapy, the patient showed a good response, with increased muscle strength and decreased creatine kinase levels. This case highlights the importance of monitoring for muscle symptoms in patients treated with anti-TNF-alpha agents and the heterogeneous clinical phenotypes that can occur with each autoantibody.