Drug-Induced Hidradenitis Suppurativa: A Case Report.

Area of Science:

• Dermatology and Immunology
• Gastroenterology

Background:

• Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition affecting hair follicles.
• Crohn's disease (CD) is a chronic inflammatory bowel disease.
• Adalimumab (Humira), an anti-tumor necrosis factor alpha (TNF-α) agent, treats both CD and HS.

Observation:

• A 35-year-old male with fistulizing CD developed severe, widespread Hurley stage III HS.
• The HS onset coincided with two years of adalimumab treatment for CD.
• Physical examination revealed extensive abscesses and sinus tracts characteristic of advanced HS.

Findings:

• The patient's HS presentation was deemed a paradoxical adverse effect of adalimumab.
• The condition was not considered a direct manifestation of his underlying Crohn's disease.
• Intravenous antibiotics were administered for the acute infectious component of the HS.

Implications:

• This case underscores the possibility of paradoxical reactions to anti-TNF-α therapies.
• Clinicians should consider paradoxical effects when new inflammatory conditions arise during treatment.
• Further investigation into the mechanisms of paradoxical hidradenitis suppurativa is warranted.