TY - JOUR T1 - Diagnosis of tuberculosis in patients with psoriasis: the need for a modified approach JF - European Respiratory Journal JO - Eur Respir J SP - 231 LP - 232 DO - 10.1183/09031936.00016611 VL - 38 IS - 1 AU - I.D. Bassukas AU - G. Gaitanis AU - S.H. Constantopoulos Y1 - 2011/07/01 UR - http://erj.ersjournals.com/content/38/1/231.1.abstract N2 - To the Editors:We read with interest the TBNET consensus statement on the diagnosis and treatment of tuberculosis (TB) in patients screened for tumour necrosis factor (TNF)-α antagonist therapy [1]. Admittedly, accumulated evidence during the last decade demonstrates that adherence to such guidelines has minimised the risk of TB reactivation in patients receiving immunosuppressive regimens, including anti-TNF-α therapy. For TNF-α antagonists specifically, targeted preventive chemotherapy prior to the onset of therapy has significantly reduced the risk of progression of latent TB infection (LTBI) to overt disease, yet at the cost of increased risk for significant treatment-associated toxicity. Thus, in an effort to avoid possible over-treatment prior to treatment with TNF-α antagonists and to accurately identify patients who would benefit from anti-TB treatment, patient cohorts inherently predisposed to overdiagnosis of LTBI should be identified. In the TBNET consensus statement, the author panel concludes: “Screening for latent infection and preventive chemotherapy against TB should not be different for patients with different underlying disease […] who are candidates for … ER -