Rheumatology: Current Research
Open Access
ISSN: 2161-1149 (Printed)
+44-77-2385-9429
ISSN: 2161-1149 (Printed)
+44-77-2385-9429
Introduction: Melanonychia, derived from the Greek terms "melas" (black) and "onyx" (nail), is characterized by brown-black discoloration of the nail plate, primarily due to melanin production. This condition can arise from two mechanisms: Melanocytic activation and melanocyte proliferation.
Case presentation: A fully human monoclonal antibody targeting Tumor Necrosis Factor (TNF), adalimumab is used to treat several immune-mediated inflammatory diseases, including rheumatoid arthritis, psoriatic arthritis, and Crohn's disease. Skin-related adverse effects account for approximately 25% of all reported side effects of anti- TNF therapies, which may only become apparent in clinical practice despite thorough preclinical studies.
Results: This case report suggests that adjusting the frequency of adalimumab therapy can effectively manage adverse effects like melanonychia while retaining the drug's therapeutic benefits. Modifying the dosing schedule led to significant improvements in nail pigmentation.
Discussion: The findings are consistent with existing literature, which documents skin-related adverse effects from TNF inhibitors, including melanonychia. This aligns with studies that highlight the potential for TNF antagonists to induce immune-mediated reactions affecting melanocyte activity.
Conclusion: The case of adalimumab-induced melanonychia underscores the need for clinicians to remain vigilant for a broad range of potential side effects. Further research is necessary to better understand the safety profile of biologic therapies and to recognize uncommon adverse effects like melanonychia
Published Date: 2024-10-28; Received Date: 2024-09-24