TLDR A patient with PPP had rare skin reactions to adalimumab, which improved after stopping smoking and continuing acitretin.
A 50-year-old male with pustulosis palmoplantaris (PPP) developed acneiform eruptions, alopecia areata (AA), and urticaria after starting adalimumab treatment. Despite switching to etanercept and other medications, his PPP persisted, though the adverse skin reactions gradually improved. The case highlighted the rare occurrence of these cutaneous reactions with adalimumab, suggesting a possible link to immune dysregulation. The patient eventually achieved remission from PPP after quitting smoking and continuing acitretin. This case underscored the complexity of managing PPP and the potential for significant adverse reactions with TNF-α inhibitors.
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