Adalimumab is a recombinant human IgG1 monoclonal antibody specific for tumor necrosis factor α (TNF-α). Pharmacologic blockade of TNF-α has proven beneficial in a variety of chronic inflammatory conditions, including rheumatoid arthritis and psoriasis.1 It has also been successfully used in the treatment of pyoderma gangrenosum,2 a noninfectious skin disorder frequently associated with rheumatoid arthritis, ulcerative colitis, or hematologic malignancy. A growing number of adverse skin reactions to anti–TNF-α agents, including local reactions at the injection site, nonspecific rashes, isolated cases of bullous skin lesions, leukocytoclastic vasculitis,3 and erythema multiforme,4 have been reported. Moreover, development of psoriasis5 during anti–TNF-α treatment has been observed.
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Patient with pyoderma gangrenosum that developed during adalimumab treatment. Photographs show continually progressing lesions after initial debridement on the face (A), right shoulder (B), and left upper arm (C).
Lesions showed rapid improvement under treatment with methylprednisolone and cyclosporine A. Photographs show the face (A), right shoulder (B), and left upper arm (C) of the same patient shown in Figure 1 after 12 weeks of follow-up.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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