Journal
DERMATOLOGY
Volume 216, Issue 4, Pages 320-323Publisher
KARGER
DOI: 10.1159/000113945
Keywords
alopecia areata; adalimumab; tumour necrosis factor alpha; tumour necrosis factor inhibitors; side effects
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Adalimumab is a fully humanized recombinant anti-tumour-necrosis-factor (TNF-alpha) monoclonal antibody which has been approved for rheumatoid arthritis, active ankylosing spondylitis, psoriatic arthritis and Crohn's disease. We report a case of alopecia areata (AA) universalis occurring 6 months after administration of adalimumab monotherapy in a patient with a long-standing history of psoriatic arthritis and psoriasis. The diagnosis was confirmed by a scalp biopsy which showed a peribulbar infiltrate of both CD4+ and CD8+ T cells, CD1a+ dendritic cells as well as CD68+ and CD163+ macrophages. In addition, immunofluorescence staining for TNF-alpha was found in the mononuclear cell infiltrate. This case suggests a complex role of TNF-alpha in the induction of AA. Copyright (c) 2008 S. Karger AG, Basel.
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