Psoriatic Alopecia and Paradoxical Psoriasis Induced by Adalimumab Successfully Treated with Certolizumab: Clinical, Trichoscopic, and in vivo Reflectance Confocal Microscopy Features.

IF 1.4 Q3 DERMATOLOGY Skin Appendage Disorders Pub Date : 2023-06-01 Epub Date: 2022-12-08 DOI:10.1159/000527985

Matteo Megna, Mario De Lucia, Lucia Gallo, Wanda Lauro, Vincenzo Picone, Gabriella Fabbrocini, Sonia Sofia Ocampo-Garza

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Abstract

Introduction: Psoriatic alopecia is considered a type of hair loss occurring in patients with psoriasis. Adalimumab is a fully humanized recombinant anti-TNF-alpha monoclonal antibody approved for treatment of psoriasis and psoriatic arthritis (PsA), rarely related to the occurrence of dermatological disorders.

Case presentation: We report the case of a 56-year-old female with PsA developing psoriatic alopecia and paradoxical psoriasis induced by adalimumab and successfully treated switching to certolizumab, evaluating response at both thrichoscopy and in vivo reflectance confocal microscopy.

Discussion: Among anti-TNF-α agents, certolizumab is the least involved in the development of paradoxical reactions such as psoriatic alopecia and showed to be an effective and safe alternative therapeutic options to manage psoriasis and PsA minimizing the risk of paradoxical reactions.

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阿达木单抗诱发的银屑病性脱发和矛盾性银屑病可使用赛妥珠单抗成功治疗：临床、三镜和体内反射共聚焦显微镜特征。

简介银屑病性脱发被认为是银屑病患者脱发的一种类型。阿达木单抗是一种全人源化重组抗肿瘤坏死因子-α单克隆抗体，被批准用于治疗银屑病和银屑病关节炎（PsA），很少与皮肤病的发生有关：我们报告了一例由阿达木单抗诱发银屑病性脱发和矛盾性银屑病的56岁女性PsA患者的病例，该患者在改用certolizumab后治疗成功，并在匍匐镜和体内反射共聚焦显微镜下评估了反应：讨论：在抗肿瘤坏死因子-α药物中，色瑞珠单抗对银屑病脱发等副反应的发生影响最小，是治疗银屑病和PsA的一种有效、安全的替代疗法，可将副反应的风险降至最低。

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