Skip to main content

Advertisement

Log in

Morphea associated with the use of adalimumab: a case report and review of the literature

  • Case Report
  • Published:
Modern Rheumatology

Abstract

Therapy with TNF blockers may induce cutaneous adverse events, but the development of morphea, a localized scleroderma lesion, is extremely infrequent. We describe a 37-year-old man with ankylosing spondylitis treated with adalimumab who developed morphea lesions in the lower limbs after 12 months of treatment. Adalimumab was discontinued, which resulted in progressive improvement in the skin lesions, with only mild hyperpigmentation remaining. We also review reports of morphea and other adverse cutaneous events related to anti-TNF treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Borrás-Blasco J, Navarro-Ruiz A, Borrás C, Casterá E. Adverse cutaneous reactions induced by TNF-alpha antagonist therapy. South Med J. 2009;102:1133–40.

    Article  PubMed  Google Scholar 

  2. Flendrie M, Vissers WH, Creemers MC, de Jong EM, van de Kerkhof PC, van Riel PL. Dermatological conditions during TNF-α-blocking therapy in patients with rheumatoid arthritis: a prospective study. Arthritis Res Ther. 2005;7:R666–76.

    Article  PubMed  CAS  Google Scholar 

  3. Lee HH, Song IH, Friedich M, et al. Cutaneous side-effects in patients with rheumatic diseases during application of tumour necrosis factor-α antagonists. Br J Dermatol. 2007;156:486–91.

    Article  PubMed  CAS  Google Scholar 

  4. Keystone EC, Kavanaugh AF, Sharp JT, et al. Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy. A randomized, placebo-controlled, 52-week trial. Arthritis Rheum. 2004;50:1400–11.

    Article  PubMed  CAS  Google Scholar 

  5. Dalmau J, Roé E, Corella F, García-Navarro X, Peramiquel L, Alomar A. Acute generalized skin eruption due to adalimumab: report of two cases. J Eur Acad Dermatol Venereol. 2007;21:1105–6.

    Article  PubMed  CAS  Google Scholar 

  6. García Bartels N, Lee HH, Worm M, Burmester GR, Sterry W, Blume-Peytavi U. Development of alopecia areata universalis in a patient receiving adalimumab. Arch Dermatol. 2006;142:1654–5.

    Article  PubMed  Google Scholar 

  7. Rajpara SN, Ormerod AD, Gallaway L. Adalimumab-induced pityriasis rosea. J Eur Acad Dermatol Venereol. 2007;21:1294–6.

    PubMed  CAS  Google Scholar 

  8. Nikas SN, Voulgari PV, Drosos AA. Urticaria and angioedema-like skin reactions in a patient treated with adalimumab. Clin Rheumatol. 2007;26:787–8.

    Article  PubMed  CAS  Google Scholar 

  9. Beuthien W, Mellinghoff HH, von Kempis J. Skin reaction to adalimumab. Arthritis Rheum. 2004;50:1690–2.

    Article  PubMed  CAS  Google Scholar 

  10. Salama M, Lawrance IC. Stevens–Johnson syndrome complicating adalimumab therapy in Crohn’s disease. World J Gastroenterol. 2009;15:4449–52.

    Article  PubMed  CAS  Google Scholar 

  11. FDA US Food and drug administration. Tumor necrosis factor alpha (TNF-α) antagonists [infliximab (marketed as REMICADE), etanercept (marketed as ENBREL), and adalimumab (marketed as HUMIRA)]: serious skin reactions. Postmarketing Rev. 2008;1(2). http://www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/ucm119034.htm#tnf.

  12. Ranganathan P. Infliximab-induced scleroderma in a patient with rheumatoid arthritis. J Clin Rheumatol. 2005;11:319–22.

    Article  PubMed  Google Scholar 

  13. Mattozzi C, Richetta AG, Cantisani C, et al. Morphea, an unusual side effect of anti-TNF-alpha treatment. Eur J Dermatol. 2010;20:400–1.

    PubMed  Google Scholar 

  14. Zulian F. New developments in localized scleroderma. Curr Opin Rheumatol. 2008;20:601–7.

    Article  PubMed  Google Scholar 

  15. Badea I, Taylor M, Rosenberg A, Foldvari M. Pathogenesis and therapeutic approaches for improved topical treatment in localized scleroderma and systemic sclerosis. Rheumatology. 2009;48:213–21.

    Article  PubMed  CAS  Google Scholar 

  16. Ihn H, Sato S, Fujimoto M, Kikuchi K, Takehara K. Demonstration of interleukin-2, interleukin-4 and interleukin-6 in sera from patients with localized scleroderma. Arch Dermatol Res. 1995;287(2):193–7.

    Article  PubMed  CAS  Google Scholar 

  17. Kurzinski K, Torok KS. Cytokines profiles in localized scleroderma and relationship to clinical features. Citokine. 2011;55:157–64.

    CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Julio Ramírez.

About this article

Cite this article

Ramírez, J., Hernández, M.V., Galve, J. et al. Morphea associated with the use of adalimumab: a case report and review of the literature. Mod Rheumatol 22, 602–604 (2012). https://doi.org/10.1007/s10165-011-0550-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10165-011-0550-4

Keywords

Navigation