GUAN-YI HETSEN-FANG TSAI2020-10-222020-10-2220121027-8117https://www.scopus.com/inward/record.uri?eid=2-s2.0-84861574162&doi=10.1016%2fj.dsi.2011.09.010&partnerID=40&md5=0a62726ab05234c78449a52a71e98070https://scholars.lib.ntu.edu.tw/handle/123456789/517658Adalimumab is a fully human immunoglobulin G1 monoclonal antibody against tumor necrosis factor (TNF)-α that is increasingly used for the treatment of many autoimmune diseases. However, it has also been reported that adalimumab can induce many adverse cutaneous reactions, including paradoxical psoriasiform eruptions. We describe a patient with pustulosis palmoplantaris who developed four cutaneous adverse reactions, including eczematous lesions, acneiform eruption, alopecia areata, and urticaria during adalimumab treatment. A common histopathological finding in these acneiform and urticarial lesions was the presence of eosinophilic infiltrates. Some authors assume that cross-regulation between TNF-α and interferon-α may contribute to development of a clinical spectrum of cutaneous reactions in predisposed individuals undergoing anti-TNF therapy. The use of different biologics, including adalimumab, etanercept, and ustekinumab, did not seem to improve pustulosis palmoplantaris disease activity in our patient. Copyright ? 2012, Taiwanese Dermatological Association. Published by Elsevier Taiwan LLC. All rights reserved.enacneadalimumabalopecia areataurticariaustekinumab[SDGs]SDG3adalimumab; alpha interferon; corticosteroid; cyclosporin; desloratadine; doxycycline; etanercept; etretin; fexofenadine; levocetirizine; methotrexate; triamcinolone acetonide; tumor necrosis factor alpha; ustekinumab; acne; adult; alopecia areata; case report; cell infiltration; coagulase negative Staphylococcus; concurrent infection; desquamation; disease activity; drug megadose; drug substitution; drug withdrawal; eczema; eosinophil; headache; hepatitis B; histopathology; human; hyperkeratosis; hypersensitivity reaction; hypertension; hypertransaminasemia; low drug dose; lymphocytic infiltration; male; palmar fascia; papule; phototherapy; Propionibacterium acnes; pruritus; pustule; pustulosis palmoplantaris; review; scalp pruritus; screening; skin allergy; skin biopsy; skin edema; skin exfoliation; skin nodule; smoking; Taiwan; tuberculosis; urticariajournal article10.1016/j.dsi.2011.09.0102-s2.0-84861574162