肿瘤坏死因子-α（TNF-α）抑制剂已被证明在风湿性关节炎、炎症性肠病和银屑病患者中具有良好的耐受性。与此同时，最近的临床实践和研究努力揭示了与TNF-α抑制剂治疗开始相关的银屑病损发生增加的情况。与此事件相关的基本机制尚未完全阐明。有必要对目前已在文献中发表的逆向性银屑病病例进行回顾与分析。此外，需要探索与良好结果相关的可能治疗方式和作用机制。本文使用PubMed和Google Scholar数据库（1992年至今）进行了系统的文献综述，对106例逆向性银屑病病例进行了回顾。最常见的发展形态是斑块型寻常型银屑病。女性占绝对优势（61.3%），最常见的潜在自身免疫性疾病为风湿性关节炎（45.3%）。此外，与银屑病病变发生的药物最常关联的是英夫利昔单抗（62.3%）。此外，研究结果表明，最有支持的作用机制涉及TNF-α抑制后浆细胞样树突状细胞（pDCs）释放干扰素-α（IFN-α）的无节制。虽然已经证明TNF-α抑制剂对风湿疾病患者有巨大好处，但逆向性银屑病病例表明，对于接受TNF-α抑制剂治疗的患者进行密切监测以便及早识别、治疗和可能改变药物机制以防止炎症病变进一步发展的重要性。版权所有 © 2023, Chokshi et al.

Tumor necrosis factor-alpha (TNF-α) inhibitors have been shown to be well tolerated among patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis. Meanwhile, more recently, clinical practice and research efforts have uncovered increasing cases of psoriatic lesion development tied to initiating treatment with a TNF-α inhibitor. The underlying mechanisms associated with this occurrence have yet to be fully elucidated. A review and analysis of cases of paradoxical psoriasis currently published in the literature is warranted. In addition, exploring possible mechanisms of action and potential treatment options associated with favorable outcomes is much needed. A systematic literature review was performed utilizing PubMed and Google Scholar databases (1992-present), in which 106 cases of paradoxical psoriasis were reviewed. The most common morphology developed was plaque psoriasis vulgaris. There was a female predominance (61.3%), and the most common underlying autoimmune disease was rheumatoid arthritis (45.3%). In addition, the most commonly associated drug with the onset of psoriatic lesions was infliximab (62.3%). Furthermore, the findings suggest that the most well-supported mechanism of action involves the uncontrolled release of interferon-alpha (IFN-α) from plasmacytoid dendritic cells (pDCs) after TNF-α inhibition. While TNF-α inhibitors have been shown to have great benefits to patients with rheumatologic diseases, cases of paradoxical psoriasis demonstrate the importance of close monitoring of patients on TNF-α inhibitors to allow for early recognition, treatment, and potentially change to a different mechanism of action of the medication used to prevent further progression of the inflammatory lesions.Copyright © 2023, Chokshi et al.