title: Type I pityriasis rubra pilaris: upregulation of tumor necrosis factor alpha and response to adalimumab therapy.
abstract: 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.
authors.affiliation: Department of Dermatology and Skin Science and Pathology and Laboratory Medicine, University of Bristish Columbia, Vancouver, BC.
authors.forename: Yao-Hua
authors.initials: YH
authors.lastname: Zhang
authors.forename: Youwen
authors.initials: Y
authors.lastname: Zhou
authors.forename: Nigel
authors.initials: N
authors.lastname: Ball
authors.forename: Ming-Wan
authors.initials: MW
authors.lastname: Su
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Xu
authors.forename: Zhi-Zhong
authors.initials: ZZ
authors.lastname: Zheng
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab