Type I pityriasis rubra pilaris: upregulation of tumor necrosis factor alpha and response to adalimumab therapy.
BACKGROUND
pityriasis rubra pilaris (PRP) has unknown etiology and is often refractory to conventional therapies.


OBJECTIVE
to document a PRP patient's response to adalimumab therapy and to highlight the potential role of tumor necrosis factor (TNF) in the development of PRP skin lesions.


METHODS
a patient received adalimumab therapy at standard dosing intervals. In addition, the messenger ribonucleic acid (mRNA) of TNF in the lesional and perilesional normal skin was quantified in two patients with PRP.


RESULTS
the patient responded to adalimumab therapy and achieved clinical remission by 4 months. There was a significant elevation of TNF mRNA in the lesional skin of PRP.


CONCLUSIONS
TNF upregulation is detected in PRP lesional skin, consistent with the observed clinical efficacy of TNF blockade for the treatment of PRP.
Zhang
Yao-Hua
YH
Department of Dermatology and Skin Science and Pathology and Laboratory Medicine, University of Bristish Columbia, Vancouver, BC.
Zhou
Youwen
Y
Ball
Nigel
N
Su
Ming-Wan
MW
Xu
Jin-Hua
JH
Zheng
Zhi-Zhong
ZZ
D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D005260:Female; D006801:Humans; D010916:Pityriasis Rubra Pilaris / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D012333:RNA, Messenger / Q000032:analysis; D012008:Recurrence; D019233:Retreatment; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology*; D015854:Up-Regulation / Q000502:physiology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab