A 52-year-old woman with a 10-pack-year smoking history presented with serious hair loss. She had a 10-year history of Crohn's disease associated with arthritis, for which she had been taking adalimumab. After 2 months of this treatment, she developed pustular lesions on her palms, soles, and scalp. Her gastroenterologist discontinued adalimumab injections, ordered skin biopsy, and switched her to ustekinumab 90-mg subcutaneous injections every 8 weeks. She then presented to our dermatology clinic, 2 months following the initiation of anti-IL12/23 medications, for her alopecia. She had no personal or family history of psoriasis. (. 2022;20:136-138).
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Tumor necrosis factor-alpha (TNF-α) inhibitors are commonly used for management of various autoimmune disorders but can rarely cause isolated cutaneous lupus. This report presents two cases of cutaneous lupus erythematosus (LE) in women aged 38 and 61 after adalimumab treatment for psoriasis highlighting the importance of recognizing these paradoxical reactions for timely management.
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