Adalimumab‐Induced Cutaneous Lupus Erythematosus in a 16‐Year‐Old Girl with Juvenile Idiopathic Arthritis

Abstract

Tumor necrosis factor α (TNF-α) antagonists are used in the treatment of numerous autoimmune conditions. Adalimumab is the first monoclonal antibody to TNF-α and is used to treat juvenile idiopathic arthritis. A growing body of literature associates anti-TNF-α therapies with several adverse dermatologic manifestations, including drug-induced lupus erythematosus (LE). We describe a case of cutaneous LE in a 16-year-old girl treated with adalimumab for juvenile idiopathic arthritis. The temporal association between her presenting symptoms and adalimumab initiation and gradual improvement after stopping biologic therapy suggest adalimumab-induced cutaneous LE. With increasing use of anti-TNF therapies in children, the potential for drug-induced LE should not be overlooked.

Cutaneous Adverse Reactions during Anti-Tnf Alpha Treatment for Inflammatory Bowel Diseases: The Experience of the Dermatology Clinic of Cagliari

“…Several inflammatory conditions are reported in anecdotal association to anti-TNF treatment, such as the lupus erythematosus, lichenoid dermatitis, urticarial reactions we also observed [13,[24][25][26][27][28][29][30]52]. Peculiar findings were the occurrence of a symptomatic photosensitivity, requiring active photo protection in two subject with IV to V Fitzpatrick phototype; an alopecia areata, and a hypertrichosis case, which are rarely reported controversial events [53][54][55][56][57].…”

“…More rarely, lupus erythematosus [24,25], acneiform eruption [26], sarcoidosis [27], anular granuloma [28], interstitial granulomatous dermatitis [29], lichenoid eruptions [30], erythema multiforme [31], leucocytoclasic vasculitis [32], purpura [33], dermatomyositis [34], eruptive benign lesions [35], and melanoma [36][37][38] are reported. In the present paper, we have focused on cutaneous adverse reactions to anti-TNFα agents and their proper management, comparing our data and results with those reported in the international literature.…”

Cutaneous lupus erythematosus induced by adalimumab: A case report

“…Four months after initiating treatment with methotrexate and an anti-TNFα drug (Adalimumab), the patient developed infiltrated erythematous plaques on both cheeks, which were exacerbated by sunlight exposure (Figure 1A bodies. 2,3 The prevalence of positive ANA ranges between 23% and 57%, and the prevalence of anti-DNA ranges between 9% and 33%.…”

“…Topical corticosteroids, topical tacrolimus ointment and intralesional corticosteroids have shown favorable effects with persistent remission of skin symptoms. 2,3,8 In these cases, close monitoring of cutaneous and systemic symptoms and laboratory follow-up should be considered. 2,3 Anti-TNFα agents have been associated with an increased number of autoimmune reactions, and their increased availability may rise adverse reactions.…”

“…2,3,8 In these cases, close monitoring of cutaneous and systemic symptoms and laboratory follow-up should be considered. 2,3 Anti-TNFα agents have been associated with an increased number of autoimmune reactions, and their increased availability may rise adverse reactions. Although systemic lupus-like reactions are a known side effect, the isolated skin-limited form is less frequent.…”