RESUMO
The patient presented with a salmon-colored rash from head to toe. The distinctive clinical presentation and a biopsy pointed to an uncommon diagnosis.
Assuntos
Acitretina/administração & dosagem , Pitiríase Rubra Pilar , Pele/patologia , Biópsia/métodos , Diagnóstico Diferencial , Feminino , Humanos , Ceratolíticos/administração & dosagem , Pessoa de Meia-Idade , Pitiríase Rubra Pilar/diagnóstico , Pitiríase Rubra Pilar/tratamento farmacológico , Pitiríase Rubra Pilar/fisiopatologia , Resultado do Tratamento , Vitamina A/análogos & derivadosRESUMO
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. CONCLUSION: TNF upregulation is detected in PRP lesional skin, consistent with the observed clinical efficacy of TNF blockade for the treatment of PRP.