Diffuse large B-cell lymphoma that develops after adalimumab using adalimumab in a patient with psoriasis

Diffuse large B-cell lymphoma that develops after adalimumab using adalimumab in a patient with psoriasis [Turkderm-Turk Arch Dermatol Venereol]

Turkderm-Turk Arch Dermatol Venereol. 2021; 55(2): 92-95 | DOI: 10.4274/turkderm.galenos.2020.34356

Diffuse large B-cell lymphoma that develops after adalimumab using adalimumab in a patient with psoriasis

Esra Y�ld�r�m Bay¹, Elif Moustafa¹, �lteris O�uz Topal¹, �zben Yal��n², Naciye Demirel³
¹PProf. Dr. Cemil Ta��o�lu City Hospital, Clinic of Dermatology, �stanbul, Turkey
²Prof. Dr. Cemil Ta��o�lu City Hospital, Clinic of Pathology, �stanbul, Turkey
³Prof. Dr. Cemil Ta��o�lu City Hospital, Clinic of Hematology, �stanbul, Turkey

Psoriasis is a polygenic, systemic inflammatory disease seen in 2% to 3% of the population and leads to a serious deterioration in the quality of life. As a result, studies on the pathophysiology of this disease have led to the development of cytokine-targeted therapies, especially the widespread use of treatments targeting tumor necrosis factor-alpha (TNF-α). The role of TNF-α in inflammation and important physiological pathways has increased safety concerns. In the literature, it has been reported that infections, cardiac failure, neurological diseases, and malignancies may develop related to the use of anti-TNF-α agents. In this case report, a 59-year-old male patient was started on adalimumab as a biological agent for erythrodermic psoriasis. Twenty-four months after starting biological agent therapy, hard nodules occurred under his skin in both the inguinal and axillary regions. The patient was diagnosed with diffuse large B-cell lymphoma based on his histopathological and laboratory examinations. This case report aims to discuss the specific malignancies that may develop from anti-TNF-α agents and the potential pathophysiological mechanisms suggested in the current literature.

Keywords: Psoriasis, adalimumab, lymphoma

Psoriazisli hastada adalimumab kullan�m� sonras�nda geli�en diff�z b�y�k B h�creli lenfoma

Esra Y�ld�r�m Bay¹, Elif Moustafa¹, �lteris O�uz Topal¹, �zben Yal��n², Naciye Demirel³
¹Prof. Dr. Cemil Ta��o�lu �ehir Hastanesi, Dermatoloji Klini�i, �stanbul, T�rkiye
²Prof. Dr. Cemil Ta��o�lu �ehir Hastanesi, Patoloji Klini�i, �stanbul, T�rkiye
³Prof. Dr. Cemil Ta��o�lu �ehir Hastanesi, Hematoloji Klini�i, �stanbul, T�rkiye

Psoriazis toplumun %2 ile %3��nde g�r�len, ya�am kalitesinde ciddi bozulmalara yol a�an poligenik, sistemik enflamatuvar bir hastal�kt�r. Hastal��n patofizyolojisinin ayd�nlat�lmas� ile ilgili �al��malar sonucunda, sitokin hedefli tedaviler geli�tirilmi�, �zellikle t�m�r nekroz fakt�r-alfay� (TNF-α) hedef alan tedavilerin kullan�m� yayg�nla�m��t�r. TNF-α�n�n sadece enflamasyonda de�il, ayn� zamanda �nemli fizyolojik yolaklarda rol oynamas� g�venlik endi�elerini art�rm��t�r. Literat�rde anti-TNF-α ajanlar�n kullan�m�na ba�l� enfeksiyonlar, kardiyak yetmezlikte art��, n�rolojik hastal�klar ve malignitelerin geli�ebilece�i bildirilmi�tir. Bu olgu sunumunda 59 ya��nda erkek hastaya eritrodermik psoriazis nedeniyle biyolojik ajan olarak adalimumab ba�lanm��t�r. Biyolojik ajan tedavisine ba�land�ktan 24 ay sonra hastan�n her iki inguinal ve aksiller b�lgesinde deri alt�nda sert nod�ller meydana gelmi�tir. Yap�lan histopatolojik tetkikler ve laboratuvar incelemeleri neticesinde hastaya diff�z b�y�k B-h�creli lenfoma tan�s� konulmu�tur. Bu olgu sunumu ile anti-TNF-α ajan kullan�m�na ba�l� geli�ebilecek malignitelerin neler olabilece�i, olas� patofizyolojik mekanizmalar� g�ncel literat�r bilgileri e�li�inde tart��lmas� ama�lanm��t�r.

Anahtar Kelimeler: Psoriazis, adalimumab, lenfoma

Esra Y�ld�r�m Bay, Elif Moustafa, �lteris O�uz Topal, �zben Yal��n, Naciye Demirel. Diffuse large B-cell lymphoma that develops after adalimumab using adalimumab in a patient with psoriasis. Turkderm-Turk Arch Dermatol Venereol. 2021; 55(2): 92-95

Corresponding Author: Esra Y�ld�r�m Bay, T�rkiye

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