Macular amyloidosis and seronegative spondyloarthritis: Causal or casual association?

TNF alpha blockade of regulatory T cells leading to accumulation of regulator T cells in the skin. It is likely that biologic agents act as immune dysregulatory agents, rather than antigenic triggers, in the accumulation of lymphocytic infiltrates. Pseudolymphomatous drug reactions are identified as rare but important side effects as targeted therapy with biologics becomes increasingly common in dermatology and specialty medicine. If the process is a true drug reaction, resolution of the rash should occur by ceasing of the inciting drug. Recurrent or progressive disease should be concerning for endogenous T-cell lymphoproliferative disease.