title: Resolution of adalimumab-induced psoriasis after vitamin D deficiency treatment.
abstract: Tumoral necrosis factor alpha blockers are very efficient in the treatment of many inflammatory systemic diseases, including rheumatoid arthritis and psoriasis. However, a paradoxical arouse of psoriasiform lesions may occur in a few patients taking anti-TNFα. The etiology of this rare side effect is still a mystery, and its treatment may be difficult. The authors report the resolution of adalimumab-induced psoriasis in a woman with rheumatoid arthritis after the use of high vitamin D(3) doses for the treatment of vitamin D deficiency. This is the first report of resolution of anti-TNFα-induced psoriasiform lesions by high doses of vitamin D(3) in a patient with rheumatoid arthritis and vitamin D deficiency. This case raises interesting questions on the role of vitamin D deficiency in the pathogenesis of this side effect and on the possible usefulness of high-dose vitamin D(3) in its treatment.
authors.affiliation: Rheumatology Unit, Universidade Federal de Santa Catarina, Florianópolis, Brazil. castrogrwc@gmail.com
authors.forename: Gláucio Ricardo
authors.initials: GR
authors.lastname: Werner de Castro
authors.forename: Fabrício Souza
authors.initials: FS
authors.lastname: Neves
authors.forename: Ivanio Alves
authors.initials: IA
authors.lastname: Pereira
authors.forename: Sonia Cristina Magalhaes Souza
authors.initials: SC
authors.lastname: Fialho
authors.forename: Giovana
authors.initials: G
authors.lastname: Ribeiro
authors.forename: Adriana Fontes
authors.initials: AF
authors.lastname: Zimmermann
mesh_terms: D000068879:Adalimumab; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002762:Cholecalciferol / Q000627:therapeutic use*; D057915:Drug Substitution; D005260:Female; D006801:Humans; D008875:Middle Aged; D011565:Psoriasis / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D012307:Risk Factors; D000069283:Rituximab; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha; D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol; D000069283:Rituximab; C104450:25-hydroxyvitamin D; D000068879:Adalimumab