Chronic Ulcer on the Tongue as a Manifestation of Histoplasmosis During Anti-tumor Necrosis Factor-Alpha (TNF-⍺) Inhibitor Therapy for Psoriasis.

Anti-tumor necrosis factor-alpha (TNF-⍺) inhibitors are commonly used in the treatment of inflammatory conditions such as psoriasis. However, these agents lead to increased susceptibility to infections. We report a patient with reactivation of latent histoplasmosis six months after starting an anti-TNF-⍺ inhibitor for the treatment of psoriasis. Dermatologists should be aware of the risks associated with initiating therapy and maintain a low threshold of suspicion for this infection in patients on anti-TNF-⍺ inhibitors presenting with oral ulcers.