Adalimumb Induced Systemic Vasculitis Following Treatment of Hidradenitis Suppurativa

ABSTRACT

A 52-year-old man, with diabetes mellitus and obesity, hadreceived Adalimumb for extensive Hidradenitis suppurativa.The latter was difficult to control with local antiseptics,antibiotics and surgery. Two weeks later, he developed fever,palpable maculopapular rash and progressive renal failure. Hisskin biopsy showed leucocytoclastic vasculitis with negativeimmune deposits and his kidney biopsy showed crescenticglomerulonephritis. Adalimumb was discontinued and thepatient was treated with Prednisone 1 mg/kg/day. His kidneyfailure improved. However, his skin lesions progressed tonecrotizing fasciitis despite aggressive surgical care.Ultimately, he died from disseminated sepses 2 months later