case_images: PMC10875046_01
case_images: Skin symptoms of CAPE and case timeline. Photographs of the patient before treatment with adalimumab: well-demarcated pink-red patches and thin plaques, bilateral cheeks and chin with sparing of the infralabial area, involvement of the trunk, and extremities:erythema and significant scaling (A), after 2 months on adalimumab therapy (B), before ustekinumab therapy (C), and after 13 months on ustekinumab therapy (D).
case_images: fmed-11-1360248-g001.jpg
case_images: PMC10875046_01_fmed-11-1360248-g001.jpg
case_images: fig1
case_images: The patient presented with well-demarcated pink-red patches and thin plaques involving bilateral cheeks and chin with sparing of the infralabial area and substantial involvement of the trunk and extremities in the form of erythema and significant scaling (Figure 1A). He started biological therapy with tumor necrosis factor-alpha (TNF-alpha) inhibitor, adalimumab, with a dose of 40 mg SC every 14 days showing clinical improvement of his skin lesions for a period of 18 months without a total remission (Figure 1B). During the next 3 months, deterioration was observed and the frequency of administering the drug was modified to every 7 days (Figure 1C). Therefore, based on available data in the literature and previously reported cases of patients with CAPE (Table 2), it was decided to increase the frequency of ustekinumab injections to every other 8 weeks with significant clinical improvement (Figure 1D).