Digital vasculitis: a late complication of anti-tumour necrosis factor alpha therapy

Anti-tumour necrosis factor alpha therapy has led to significant advancement in the treatment of rheumatological disease. Rarely, anti-TNF alpha antagonists have been associated with vasculitis, predominantly cutaneous leukocytoclastic vasculitis. We present the first case of angiographically-confirmed digital vasculitis occurring as a late complication of etanercept therapy. Our case adds to the limited repertoire of case reports of anti-TNF alpha induced vasculitis and highlights the potential risk of this serious complication occurring up to several years after initiation of these agents.