case_images: PMC10720432_01
case_images: Clinical course: (A,B) under treatment with acitretin 25 mg/d and topical steroids, (C,D) 4 weeks after initiation of adalimumab biosimilar, (E,F) 2 months of increased interval 1/week and addition of montelukast 10 mg/d, (G,H) 4 months after dose optimization of adalimumab to 2 weeks and 3 weeks.
case_images: fmed-10-1295777-g001.jpg
case_images: PMC10720432_01_fmed-10-1295777-g001.jpg
case_images: fig1
case_images: This condition also involved the face and had developed over the past 8 months (Figures 1A,B). As skin lesions worsened a month later, we decided to shorten the interval for adalimumab administration to once weekly (Figures 1C,D). Within 4 weeks, both the skin lesions and pruritus showed significant improvement, enabling a reduction in adalimumab dosage to 40 mg every 2 weeks (Figures 1E,F). Notably, there were no disease flares during the subsequent 4 months of follow-up (Figures 1G,H).
case_images: Histopathologic findings showing acanthosis, alternated areas of parakeratosis and orthokeratosis and a dermal mainly perivascular lymphoplasmatic infiltrate (original magnification x 100; hematoxylin and eosin [H&E]).
case_images: fmed-10-1295777-g002.jpg
case_images: PMC10720432_01_fmed-10-1295777-g002.jpg
case_images: fig2
case_images: Histopathological examination revealed acanthosis, alternated areas of parakeratosis and orthokeratosis and a dermal mainly perivascular lymphoplasmatic infiltrate (Figure 2).