Peritoneal tuberculosis in the setting of ustekinumab treatment for psoriasis

Biologics have revolutionized the treatment of moderate-to-severe psoriasis, but serious infection is a risk with these immunosuppressive agents.1 An increased risk of tuberculosis (TB) reactivation in patients with latent TB infection is well recognized with anti–tumor necrosis factor (TNF)-α agents, as TNF has a central role in TB immunity, and anti–TNF-α agents interfere with innate and cell-mediated immune responses.2 Testing for and treating latent TB before starting therapy reduces the risk of reactivation of TB on biologic agents.