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image of Facial Hyperpigmentation Following Adalimumab

Abstract

Background

Tumor necrosis factor alpha (TNF-α) inhibitors, such as adalimumab, have significantly advanced the treatment of inflammatory diseases. However, these therapies are associated with various cutaneous adverse reactions.

Case Presentation

We describe two rare instances of isolated facial hyperpigmentation induced by adalimumab. Both patients presented with asymptomatic, isolated brown macules on the cheeks following adalimumab treatment for ankylosing spondylitis. The hyperpigmentation appeared shortly after starting the medication in both cases. In one case, the hyperpigmentation persisted despite stopping the medication, while in the second case, it completely resolved within one month after discontinuation. However, in the second patient, the hyperpigmentation recurred after switching to certolizumab, another TNF-α inhibitor. No skin biopsies were performed, and both patients were otherwise healthy, with normal laboratory evaluations.

Conclusion

Hyperpigmentation is an uncommon adverse reaction of this class of drugs, with only a few reported cases in the literature. The recurrence of hyperpigmentation after switching to another TNF-α agent, certolizumab, further suggests that this reaction may be a class effect, adding new insights into the spectrum of cutaneous side effects associated with TNF-α inhibitors. Clinicians should consider this potential side effect in patients presenting with hyperpigmentation, and sun protection should be recommended as a preventive measure.

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2024-10-31
2025-01-27

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References

  1. Leone G.M. Mangano K. Petralia M.C. Nicoletti F. Fagone P. Past, present and (foreseeable) future of biological anti-TNF alpha therapy. J. Clin. Med. 2023 12 4 1630 10.3390/jcm12041630 36836166
    [Google Scholar]
  2. Lopetuso L.R. Cuomo C. Mignini I. Gasbarrini A. Papa A. Focus on anti-tumour necrosis factor (tnf)-α-related autoimmune diseases. Int. J. Mol. Sci. 2023 24 9 8187 10.3390/ijms24098187 37175894
    [Google Scholar]
  3. Mocci G. Marzo M. Papa A. Armuzzi A. Guidi L. Dermatological adverse reactions during anti-TNF treatments: Focus on inflammatory bowel disease. J. Crohn’s Colitis 2013 7 10 769 779 10.1016/j.crohns.2013.01.009 23453887
    [Google Scholar]
  4. Au M. Heddle G. Young E. Ryan E. Graf S. Tee D. Philpott H. Anti‐tumour necrosis factor‐induced skin rashes in inflammatory bowel disease: A systematic review and evidence‐based management algorithm. Intern. Med. J. 2023 53 10 1854 1865 10.1111/imj.15859 35760771
    [Google Scholar]
  5. Hernández M.V. Sanmartí R. Cañete J.D. Descalzo M.A. Alsina M. Carmona L. Gomez-Reino J.J. Cutaneous adverse events during treatment of chronic inflammatory rheumatic conditions with tumor necrosis factor antagonists: study using the Spanish registry of adverse events of biological therapies in rheumatic diseases. Arthritis Care Res. 2013 65 12 2024 2031 10.1002/acr.22096 23926075
    [Google Scholar]
  6. Lindhaus C. Tittelbach J. Elsner P. Cutaneous side effects of TNF-alpha inhibitors. J. Dtsch. Dermatol. Ges. 2017 15 3 281 288 28252861
    [Google Scholar]
  7. Blomberg M. Zachariae C.O.C. Grønhøj F. Hyperpigmentation of the face following adalimumab treatment. Acta Derm. Venereol. 2009 89 5 546 547 10.2340/00015555‑0697 19734995
    [Google Scholar]
  8. Ellis C.R. Azmat C.E. Adalimumab. StatPearls. Treasure Island, FL StatPearls Publishing 2024
    [Google Scholar]
  9. Kamal M.E. Werida R.H. Radwan M.A. Efficacy and safety of infliximab and adalimumab in inflammatory bowel disease patients. Inflammopharmacol. 2024 32 3259 3269 10.1007/s10787‑024‑01508‑w
    [Google Scholar]
  10. Downes M.R. Prendiville S. Kiely C. Lenane P. Mulligan N. Cutaneous reactions to adalimumab administration. Ir. Med. J. 2011 104 4 122 123 21675098
    [Google Scholar]
  11. Wang J. Yin X. Yu L. Cheng W. Wang L. Zhao B. Li Z. Jing X. Delayed cutaneous hypersensitivity reactions following the use of infliximab or adalimumab in patients with coronavirus disease 2019. J. Med. Virol. 2023 95 2 e28518 10.1002/jmv.28518 36700393
    [Google Scholar]
  12. Beuthien W. Mellinghoff H.U. von Kempis J. Skin reaction to adalimumab. Arthritis Rheum. 2004 50 5 1690 1692 10.1002/art.20155 15146441
    [Google Scholar]
  13. Gil F. Andrade I. Aranha J. Hyperpigmentation as a rare side effect of adalimumab. Int. J. Dermatol. 2021 60 3 e105 e106 10.1111/ijd.15268 33107034
    [Google Scholar]
  14. Bégaud B. Lagier G. Vincens M. Lefebure B. Frêlon J.H. Imputabilité des effets indésirables des médicaments. Therapie 1985 40 111 118 4002188
    [Google Scholar]
  15. Cestari T.F. Dantas L.P. Boza J.C. Acquired hyperpigmentations. An. Bras. Dermatol. 2014 89 1 11 25 10.1590/abd1806‑4841.20142353 24626644
    [Google Scholar]
  16. Wang R.F. Ko D. Friedman B.J. Lim H.W. Mohammad T.F. Disorders of hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. J. Am. Acad. Dermatol. 2023 88 2 271 288 10.1016/j.jaad.2022.01.051 35151757
    [Google Scholar]
  17. Nautiyal A. Wairkar S. Management of hyperpigmentation: Current treatments and emerging therapies. Pigment Cell Melanoma Res. 2021 34 6 1000 1014 10.1111/pcmr.12986 33998768
    [Google Scholar]
  18. Yamamoto N. Dejima A. Hasatani K. Minocycline-induced hyperpigmentation in a patient with prurigo pigmentosa. BMJ Case Rep. 2021 14 6 e244365 10.1136/bcr‑2021‑244365 34140334
    [Google Scholar]
  19. Lipsker D. Lenormand C. Hyperpigmentations. Ann. Dermatol. Venereol. 2019 146 10 666 682 10.1016/j.annder.2019.05.005 31537319
    [Google Scholar]
  20. Das S. Hyperpigmentation in Dermatologic Disorders. 2022
    [Google Scholar]
  21. Syder N.C. Quarshie C. Elbuluk N. Disorders of facial hyperpigmentation. Dermatol. Clin. 2023 41 3 393 405 10.1016/j.det.2023.02.005 37236709
    [Google Scholar]
  22. Thakur V. Bakshi S. Bishnoi A. Adalimumab-induced photosensitivity and oral erosions in rheumatoid arthritis. Postgrad. Med. J. 2020 96 1140 631 632 10.1136/postgradmedj‑2019‑137329 31896550
    [Google Scholar]
  23. Alrashidi A. Rhodes L.E. Sharif J.C.H. Kreeshan F.C. Farrar M.D. Ahad T. Systemic drug photosensitivity—Culprits, impact and investigation in 122 patients. Photodermatol. Photoimmunol. Photomed. 2020 36 6 441 451 10.1111/phpp.12583 32564400
    [Google Scholar]
  24. García R.M. Molina S. Drug-induced hyperpigmentation: Review and case series. J. Am. Board Fam. Med. 2019 32 4 628 638 10.3122/jabfm.2019.04.180212 31300585
    [Google Scholar]
  25. Eichenfield D.Z. Cohen P.R. Amitriptyline-induced cutaneous hyperpigmentation: case report and review of psychotropic drug-associated mucocutaneous hyperpigmentation. Dermatol Online J. 2016 22 2 13030/qt3455571b 10.5070/D3222030090
    [Google Scholar]
  26. Nahhas A.F. Braunberger T.L. Hamzavi I.H. An update on drug-induced pigmentation. Am. J. Clin. Dermatol. 2019 20 1 75 96 10.1007/s40257‑018‑0393‑2 30374894
    [Google Scholar]
  27. Krause W. Drug‐induced hperpigemntation: a systematic review. J. Dtsch. Dermatol. Ges. 2013 11 7 644 651 10.1111/ddg.12042 23650908
    [Google Scholar]
  28. Bertrand A.S. Costa K. Dereure O. Pallure V. Une pigmentation atypique et inhabituelle du visage sous adalimumab. Ann. Dermatol. Venereol. 2017 144 12 S332 S333 10.1016/j.annder.2017.09.565
    [Google Scholar]
  29. Panda P.K. Sharawat I.K. Yadav R. Methotrexate-induced hyperpigmentation over sun-exposed area. J. Clin. Rheumatol. 2021 27 7 e287 e288 10.1097/RHU.0000000000001428 32541613
    [Google Scholar]
  30. Alsisi G.G. Alsisi M.H. Alhowaish A.K. Alshammari W.S. Erythema dyschromicum perstans after adalimumab treatment. Cureus 2022 14 12 e32264 36620779
    [Google Scholar]
  31. Garcovich S. Burlando M. Rongioletti F. Garcovich A. Parodi A. Amerio P. Cutaneous drug eruption with an interface dermatitis pattern due to anti-tumour necrosis factor-alpha agents: A relevant class-effect. Acta Derm. Venereol. 2010 90 3 311 312 10.2340/00015555‑0839 20526559
    [Google Scholar]
  32. Singh M. Mansuri M.S. Kadam A. Palit S.P. Dwivedi M. Laddha N.C. Begum R. Tumor Necrosis Factor-alpha affects melanocyte survival and melanin synthesis via multiple pathways in vitiligo. Cytokine 2021 140 155432 10.1016/j.cyto.2021.155432 33517195
    [Google Scholar]
  33. Zattra E. Fortina A.B. Bordignon M. Piaserico S. Alaibac M. Immunosuppression and melanocyte proliferation. Melanoma Res. 2009 19 2 63 68 10.1097/CMR.0b013e328322fc20 19194340
    [Google Scholar]
  34. Bardazzi F. Magnano M. Antonucci V.A. Balestri R. Sgubbi P. Patrizi A. Lentigines in previous psoriatic plaques in a patient treated with infliximab. Eur. J. Dermatol. 2012 22 5 698 699 10.1684/ejd.2012.1818 22940696
    [Google Scholar]
/content/journals/cds/10.2174/0115748863357040241025051122
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Facial Hyperpigmentation Following Adalimumab
Bentham Science Publishers ; https://doi.org/10.2174/0115748863357040241025051122
/content/journals/cds/10.2174/0115748863357040241025051122
/content/journals/cds/10.2174/0115748863357040241025051122
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  • Article Type:     Case Report
Keywords: adverse effects ; drug-induced hyperpigmentation ; cutaneous adverse reaction ; pigmentary disorders ; TNF-α inhibitors ; Adalimumab

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