Alshehri Hamza, Alshehri Afnan, Bin Abbas Abrar
Dermatology, Asir Central Hospital, Abha, SAU.
Cureus. 2023 Feb 22;15(2):e35317. doi: 10.7759/cureus.35317. eCollection 2023 Feb.
Adalimumab is a blocker of tumor necrosis factor (TNF)-alpha with established efficacy in the treatment of ulcerative colitis. However, literature indicated that adalimumab can, occasionally, induce paradoxical psoriasis reactions and, very rarely, dermatitis herpetiformis. We present a unique case of a 26-year-old female patient who developed a combination of dermatitis herpetiformis and scalp psoriasis paradoxically as a result of adalimumab treatment for ulcerative colitis. To the best of our knowledge, this is the first case of such a combination within the context of adalimumab therapy. The etiopathological underpinning of such a reaction remains elusive but is speculated to be complex and involves the interaction of several immunological and dermatological mechanisms. Adalimumab therapy is associated with a genuine risk for the development of paradoxical psoriasis and dermatitis herpetiformis. We, through this case report, added to the evidence confirming such an association. Clinicians should follow these potential adverse effects and make every effort to warn patients of their likelihood.
阿达木单抗是一种肿瘤坏死因子（TNF）-α阻滞剂，在治疗溃疡性结肠炎方面已证实具有疗效。然而，文献表明，阿达木单抗偶尔会诱发矛盾性银屑病反应，且极罕见地会诱发疱疹样皮炎。我们报告了一例独特的病例，一名26岁女性患者在接受阿达木单抗治疗溃疡性结肠炎时，矛盾地出现了疱疹样皮炎和头皮银屑病的合并症状。据我们所知，这是阿达木单抗治疗背景下首例出现这种合并症状的病例。这种反应的病因学基础尚不清楚，但推测很复杂，涉及多种免疫和皮肤病学机制的相互作用。阿达木单抗治疗与矛盾性银屑病和疱疹样皮炎的发生存在真正风险。我们通过本病例报告补充了证实这种关联的证据。临床医生应关注这些潜在不良反应，并尽一切努力向患者警示其发生可能性。
