Successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor (TNF)-alpha inhibitor
Purpose: To report the clinical and histopathologic features of necrobiosis lipoidica and associated retinal vasculitis and describe successful treatment of both skin and eye manifestations with adalimumab, a tumor necrosis factor (TNF)-alpha inhibitor. Observations: A 35-year-old patient with bipol...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993623001160 |
| _version_ | 1797399097485819904 |
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| author | Ketaki Panse Manuela Herrera Maxwell Fung Alain Brassard Kareem Moussa |
| author_facet | Ketaki Panse Manuela Herrera Maxwell Fung Alain Brassard Kareem Moussa |
| author_sort | Ketaki Panse |
| collection | DOAJ |
| description | Purpose: To report the clinical and histopathologic features of necrobiosis lipoidica and associated retinal vasculitis and describe successful treatment of both skin and eye manifestations with adalimumab, a tumor necrosis factor (TNF)-alpha inhibitor. Observations: A 35-year-old patient with bipolar disorder and ocular hypertension was referred for evaluation of bilateral retinal vasculitis. Fluorescein angiography revealed bilateral occlusive retinal vasculitis. Physical exam was notable for multiple annular and round erythematous hyperpigmented and atrophic patches and plaques on both lower extremities. Skin biopsy revealed a diagnosis of necrobiosis lipoidica, a rare granulomatous skin disease. Both the patient's retinal vasculitis and skin patches responded favorably to treatment with adalimumab, a TNF-alpha inhibitor. Conclusions and importance: This case highlights the importance of obtaining a complete history and physical exam in patients who present with ocular inflammation, as extraocular manifestations of disease may be present. It also demonstrates the effectiveness of a multidisciplinary approach to evaluation and management of these patients, as both skin and eye involvement were successfully treated with adalimumab, a TNF-alpha inhibitor. |
| first_indexed | 2024-03-09T01:34:33Z |
| format | Article |
| id | doaj.art-c344729fead54d6990dcb66ec843bd4e |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-03-09T01:34:33Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-c344729fead54d6990dcb66ec843bd4e2023-12-09T06:07:12ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362023-12-0132101908Successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor (TNF)-alpha inhibitorKetaki Panse0Manuela Herrera1Maxwell Fung2Alain Brassard3Kareem Moussa4Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USAUniversity of California, Davis, School of Medicine, Sacramento, CA, USADepartment of Dermatology, University of California, Davis, Sacramento, CA, USADepartment of Dermatology, University of California, Davis, Sacramento, CA, USADepartment of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USA; Corresponding author. UC Davis Department of Ophthalmology & Vision Science, 4860 Y Street, Ernest E. Tschannen Eye Institute, Sacramento, CA, 95817, USA.Purpose: To report the clinical and histopathologic features of necrobiosis lipoidica and associated retinal vasculitis and describe successful treatment of both skin and eye manifestations with adalimumab, a tumor necrosis factor (TNF)-alpha inhibitor. Observations: A 35-year-old patient with bipolar disorder and ocular hypertension was referred for evaluation of bilateral retinal vasculitis. Fluorescein angiography revealed bilateral occlusive retinal vasculitis. Physical exam was notable for multiple annular and round erythematous hyperpigmented and atrophic patches and plaques on both lower extremities. Skin biopsy revealed a diagnosis of necrobiosis lipoidica, a rare granulomatous skin disease. Both the patient's retinal vasculitis and skin patches responded favorably to treatment with adalimumab, a TNF-alpha inhibitor. Conclusions and importance: This case highlights the importance of obtaining a complete history and physical exam in patients who present with ocular inflammation, as extraocular manifestations of disease may be present. It also demonstrates the effectiveness of a multidisciplinary approach to evaluation and management of these patients, as both skin and eye involvement were successfully treated with adalimumab, a TNF-alpha inhibitor.http://www.sciencedirect.com/science/article/pii/S2451993623001160Occlusive retinal vasculitisNecrobiosis lipoidicaTumor necrosis factor-alpha inhibitorUveitis |
| spellingShingle | Ketaki Panse Manuela Herrera Maxwell Fung Alain Brassard Kareem Moussa Successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor (TNF)-alpha inhibitor American Journal of Ophthalmology Case Reports Occlusive retinal vasculitis Necrobiosis lipoidica Tumor necrosis factor-alpha inhibitor Uveitis |
| title | Successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor (TNF)-alpha inhibitor |
| title_full | Successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor (TNF)-alpha inhibitor |
| title_fullStr | Successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor (TNF)-alpha inhibitor |
| title_full_unstemmed | Successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor (TNF)-alpha inhibitor |
| title_short | Successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor (TNF)-alpha inhibitor |
| title_sort | successful treatment of necrobiosis lipoidica and associated retinal vasculitis with tumor necrosis factor tnf alpha inhibitor |
| topic | Occlusive retinal vasculitis Necrobiosis lipoidica Tumor necrosis factor-alpha inhibitor Uveitis |
| url | http://www.sciencedirect.com/science/article/pii/S2451993623001160 |
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