Reactions 1477, p5 - 9 Nov 2013

★Adalimumab

Halo naevi (first report) and deterioration of vitiligo:2 case reports

One man developed new-onset halo naevi and another mandeveloped a deterioration of his existing vitiligo duringtreatment with SC adalimumab 40mg every alternate week forlong-standing ankylosing spondylitis.

A 30-year-old man, with no personal or family history ofhalo naevi, began receiving adalimumab and, within 6 months,he presented with more than 10 halo naevi on his limbs andtrunk. Several junctional naevi were surrounded by aperipheral ring of depigmentation. There were no dysplasticfeatures. He continued receiving adalimumab and had nofurther progression of his skin condition.

A 57-year-old man, who had a history of stable vitiligo with asingle depigmented macule on his foot (unchanged for20 years), began receiving adalimumab. Within 3 months, hedeveloped rapid deterioration of his vitiligo and presented witha symmetrical distribution of numerous well-demarcateddepigmented macules on his hands, face and axillae. Initialtopical treatment with clobetasol and tacrolimus wasunsuccessful and adalimumab was then withdrawn. Partialrepigmentation was subsequently observed with continuedtopical treatment.

Author comment: "Our cases represent the fifth case ofvitiligo and the second case of halo naevi attributable to anti-TNF therapies".Maruthappu T, et al. Deterioration of vitiligo and new onset of halo naevi observedin two patients receiving adalimumab. Dermatologic Therapy 26: 370-372, No. 4,Aug 2013. Available from: URL: http://dx.doi.org/10.1111/dth/.12002 - UnitedKingdom 803095277

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of halo naevusassociated with adalimumab. The WHO ADR databasecontained 70 reports of melanocytic naevus associated withadalimumab.

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Reactions 9 Nov 2013 No. 14770114-9954/13/1477-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved