Pelivani, NedzmidinNedzmidinPelivaniHassan, Akmal SAkmal SHassanBraathen, Lasse RLasse RBraathenHunger, RobertRobertHungerYawalkar, NikhilNikhilYawalkar2024-10-132024-10-132008https://boris-portal.unibe.ch/handle/20.500.12422/101081Adalimumab is a fully humanized recombinant anti-tumour-necrosis-factor (TNF-alpha) monoclonal antibody which has been approved for rheumatoid arthritis, active ankylosing spondylitis, psoriatic arthritis and Crohn's disease. We report a case of alopecia areata (AA) universalis occurring 6 months after administration of adalimumab monotherapy in a patient with a long-standing history of psoriatic arthritis and psoriasis. The diagnosis was confirmed by a scalp biopsy which showed a peribulbar infiltrate of both CD4+ and CD8+ T cells, CD1a+ dendritic cells as well as CD68+ and CD163+ macrophages. In addition, immunofluorescence staining for TNF-alpha was found in the mononuclear cell infiltrate. This case suggests a complex role of TNF-alpha in the induction of AA.enarticle10.48350/276781823098000025391200000710.1159/000113945