title: Observational case series on adalimumab-induced paradoxical hidradenitis suppurativa.
abstract: BACKGROUND
  Although the efficacy of TNF blockers has been demonstrated in hidradenitis suppurativa (HS), many paradoxical effects have also been described with TNF antagonists. We wished to describe patients with adalimumab (ADA)-induced paradoxical HS.
  
  
  METHODS
  This is a retrospective descriptive case series of four patients with ADA-induced paradoxical HS.
  
  
  RESULTS
  All the patients had a good response to TNFa antagonist therapy at the time of HS occurrence. The time from TNFa antagonist initiation to HS onset or exacerbation ranged from a few weeks to 24 months. The outcome of HS was variable. Systemic antibiotics were required in all the cases to control HS. TNF blockers were continued in three cases with a switch to another anti-TNF class in one case. Switch to ustekinumab was prescribed in one patient with SA and Crohn's disease.
  
  
  CONCLUSIONS
  Although the imputability of TNF blockers in paradoxical HS is still debatable, further research and observation are needed to confirm and distinguish patients with genetic and clinical predisposition in the onset or exacerbation of HS during anti-TNF treatment.
authors.affiliation: a Department of Dermatology , University Hospital , Besançon , France .
authors.forename: Marine
authors.initials: M
authors.lastname: Delobeau
authors.affiliation: a Department of Dermatology , University Hospital , Besançon , France .|b Department of Dermatology , IBN SINA University Hospital , Rabat , Morocco .
authors.forename: Ahlam
authors.initials: A
authors.lastname: Abdou
authors.affiliation: a Department of Dermatology , University Hospital , Besançon , France .
authors.forename: Eve
authors.initials: E
authors.lastname: Puzenat
authors.affiliation: a Department of Dermatology , University Hospital , Besançon , France .
authors.forename: Elise
authors.initials: E
authors.lastname: Deveza
authors.affiliation: a Department of Dermatology , University Hospital , Besançon , France .
authors.forename: Caroline
authors.initials: C
authors.lastname: Biver-Dalle
authors.affiliation: a Department of Dermatology , University Hospital , Besançon , France .
authors.forename: Alison
authors.initials: A
authors.lastname: van de Laak
authors.affiliation: a Department of Dermatology , University Hospital , Besançon , France .
authors.forename: Blandine
authors.initials: B
authors.lastname: Roche-Kubler
authors.affiliation: c Department of Gastroenterology , University Hospital , Besançon , France .|d University of Franche Comté , EA3181 SFR FED 4234 , Besançon , France , and.
authors.forename: Lucine
authors.initials: L
authors.lastname: Vuitton
authors.affiliation: c Department of Gastroenterology , University Hospital , Besançon , France .
authors.forename: Stéphane
authors.initials: S
authors.lastname: Koch
authors.affiliation: e Department of Rheumatology , University Hospital , Besançon , France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.affiliation: a Department of Dermatology , University Hospital , Besançon , France .|d University of Franche Comté , EA3181 SFR FED 4234 , Besançon , France , and.
authors.forename: François
authors.initials: F
authors.lastname: Aubin
mesh_terms: D000068879:Adalimumab / Q000009:adverse effects*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001168:Arthritis / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy; D003879:Dermatologic Agents / Q000627:therapeutic use; D057915:Drug Substitution; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D017497:Hidradenitis Suppurativa / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D000069549:Ustekinumab / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D005938:Glucocorticoids; D014409:Tumor Necrosis Factor-alpha; D000069549:Ustekinumab; D000068879:Adalimumab
keywords: adalimumab; adverse effect; anti-TNF; hidradenitis suppurativa; paradoxical reaction