Pityriasis rubra pilaris (PRP) is an uncommon papulosquamous eruption of uncertain cause. The disease is typically indolent and recalcitrant to treatment and sometimes progresses to erythroderma. Methotrexate, oral retinoids, cyclosporine, and phototherapy are traditional treatments but are limited by modest efficacy and dose-dependent adverse effects.1 The tumor necrosis factor (TNF) inhibitors infliximab and etanercept have been reported to be effective for PRP in individual case reports.2,3 Adalimumab is a fully humanized monoclonal IgG1 antibody with a high affinity and specificity for human TNF.4 This subcutaneously injected medication has shown safety and efficacy in the treatment of rheumatoid arthritis, ankylosing spondylitis, Crohn disease, psoriatic arthritis, and recently psoriasis.4 To our knowledge, we report herein the first case of PRP responding to adalimumab therapy.
Walling HW, Swick BL. Pityriasis Rubra Pilaris Responding Rapidly to Adalimumab. Arch Dermatol. 2009;145(1):99-101. doi:10.1001/archdermatol.2008.527