Psoriasiform eruption induced by adalimumab in a patient with rheumatoid arthritis : a case report and review of literature

Abstract

A 72-year-old man developed arthritis of the bilateral shoulders and fingers. X-ray examination of the fingers showed periarticular osteoporosis, joint space narrowing, and cystic changes at the bone ends. Because contrast-enhanced MRI revealed synovial membrane proliferation and osteolysis, a diagnosis of rheumatoid arthritis (RA) was made. Treatment for RA with methotrexate (4 mg/week) was initiated in December 2008. In February 2009, adalimumab administration (40 mg/2 weeks) was initiated. The RA markedly improved, and clinical remission was maintained thereafter. However, in April 2010, relatively well-delineated erythematous plaques accompanied by bullae and scales developed on the bilateral palms, toes, limbs, and the inguinal region. A diagnosis of psoriasis-like eruptions was made by skin biopsy, and adalimumab administration was discontinued. After 4 months, the eruptions improved. Psoriasis-like eruptions due to anti-TNF drugs are rarely observed, but adverse effects require caution. This case is reported along with a review of the literature.

Reduction in Tumor Lesions and Exacerbation of Psoriatic Rash after Septic Shock in a Patient with Extramammary Paget’s Disease

“…We focused on the transition of tumor lesions, psoriatic rash, and tumor markers before and after septic shock and the connection of TNF-α [ 1 ] in the current patient. Carcinoembryonic antigen and cancer antigen 19-9 levels were lower than previous data at the time of severe infection, and the tumor lesions also simultaneously improved.…”