P66 Perforating dermatosis in a young female patient receiving adalimumab biosimilar CTP-17 for chronic plaque psoriasis
Year: 2024
Type: article
Study design: Case Report
Abstract: Opportunistic infections, reactivation of latent tuberculosis, demyelinating diseases were found to be the most severe adverse events associated with adalimumab. Among TNF-a inhibitors-related cutaneous adverse reactions, paradoxical reactions are the most common, whereas sweet-like neutrophilic dermatosis or perforating dermatosis have been rarely reported. A 34-year-old Caucasian woman was referred to the outpatient clinic of the University Hospital of Verona for acute onset of diffuse erythematous plaques with concentric hyperkeratosis and ulceration localized on the right thigh, right glutaeal area and elbows bilaterally, associated with pain and difficulties in walking. The acute skin reaction occurred 3 days after the switching to adalimumab biosimilar CTP17. In particular, the patient affected by chronic plaque psoriasis and psoriatic arthritis had been successfully treated with adalimumab biosimilar GP2017 for 2 years, which was later switched to CTP17 for non-medical reasons. The patient did not report any comorbidities or known allergies and was not taking other medications apart from the adalimumab biosimilar. No other symptoms were reported. The skin lesions were biopsied, and the histological examination revealed areas of epidermal ulceration, overlaid by dendritic-granulocytic crust associated with transepidermal elimination of elastic fibres (elastin). Dermal infiltrate with a rich plasma cellular component was also present. The histological diagnosis was consistent with acquired perforating dermatosis. Fungal, bacterial and mycobacterial cultures were negative. Consequently, adalimumab biosimilar CTP17 was suspended and a 30-day course of systemic therapy with corticosteroids was prescribed. After ∼60 days the cutaneous lesions progressively improved, and the ulcers have been re-epithelized, with a residual post-inflammatory erythema. Perforating dermatosis is usually associated with conditions such as trauma, diabetes, chronic renal failure and lymphoma, but is occasionally also triggered by drugs including biologics such as adalimumab, infliximab, etanercept and risankizumab.
Source: British Journal of Dermatology
Language: English
Topic: Skin Diseases and Diabetes
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4405229328