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Correspondence |

Occurrence of Penile Intraepithelial Neoplasia Following Adalimumab Treatment for Psoriatic Arthritis

Alexander Kreuter, MD; Martin F. Meyer, MD; Ulrike Wieland, MD
Arch Dermatol. 2011;147(8):1001-1002. doi:10.1001/archdermatol.2011.218.
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Biological therapies targeting tumor necrosis factor (TNF) have become increasingly used agents in the fields of dermatology and rheumatology. It is well known that TNF inhibitors may increase the susceptibility for bacterial and mycobacterial disease. In contrast, the risk of viral infections under treatment with TNF inhibitors is less well appreciated.1 We herein report on the development of multifocal penile intraepithelial neoplasia (PIN) following anti-TNF therapy with adalimumab.

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Figure 1. Patient's clinical presentation at the first visit in our institution. Multifocal flat papules and plaques are present on the penile shaft and inner part of the prepuce.

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Figure 2. Immunohistochemical analysis of p16INK4a, an indirect marker of high-risk human papillomavirus E7 oncogene expression. Nuclear and cytoplasmic staining reaching up to the upper epidermis is present in the biopsy specimen of a representative skin lesion (hematoxylin stain, original magnification ×100).

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