effects did not improve with standard treatment the drug was discontinued and symptomatology disappeared in a few days. Adalimumab is a very useful drug, but we consider that all side-effects, even those of low incidence, should be evaluated to avoid diagnostic delays and unnecessary treatments. fig. 2 (a) Six months postoperatively, the patient developed deformity of the fingertips; (b) 2 years postoperatively the fingertip deformities had disappeared.

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