Adalimumab-Induced Cutaneous Lupus Erythematosus in a 16-Year-Old Girl with Juvenile Idiopathic Arthritis

Pediatr Dermatol. 2015 Jul-Aug;32(4):e140-4. doi: 10.1111/pde.12576. Epub 2015 Apr 6.

Abstract

Tumor necrosis factor α (TNF-α) antagonists are used in the treatment of numerous autoimmune conditions. Adalimumab is the first monoclonal antibody to TNF-α and is used to treat juvenile idiopathic arthritis. A growing body of literature associates anti-TNF-α therapies with several adverse dermatologic manifestations, including drug-induced lupus erythematosus (LE). We describe a case of cutaneous LE in a 16-year-old girl treated with adalimumab for juvenile idiopathic arthritis. The temporal association between her presenting symptoms and adalimumab initiation and gradual improvement after stopping biologic therapy suggest adalimumab-induced cutaneous LE. With increasing use of anti-TNF therapies in children, the potential for drug-induced LE should not be overlooked.

Publication types

  • Case Reports

MeSH terms

  • Adalimumab / adverse effects*
  • Adolescent
  • Anti-Inflammatory Agents / adverse effects*
  • Arthritis, Juvenile / drug therapy*
  • Biopsy
  • Female
  • Humans
  • Lupus Erythematosus, Cutaneous / chemically induced*
  • Lupus Erythematosus, Cutaneous / pathology
  • Skin / pathology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Anti-Inflammatory Agents
  • Tumor Necrosis Factor-alpha
  • Adalimumab