Relapsing polychondritis associated with psoriasis vulgaris successfully treated with adalimumab: A case report with published work review

J Dermatol. 2017 Jul;44(7):826-829. doi: 10.1111/1346-8138.13796. Epub 2017 Mar 7.

Abstract

Relapsing polychondritis (RP) is a rare autoimmune-mediated disease characterized by inflammation involving cartilaginous tissues. We report here a case of RP in a 38-year-old Japanese man with 13-year duration of psoriasis vulgaris treated with topical steroids and vitamin D3 . The patient presented with tender swelling and erythema of both auricles, and the antibody to type II collagen was detected. The biopsy specimen revealed a dense mixed cell infiltration over the auricular cartilage. We reviewed eight cases with the association of RP and psoriasis, and in all cases the clinical course of psoriasis did not correlate with that of RP. The severity of RP was mild in the majority of cases, and our case was unique in that the patient had no joint symptoms. Adalimumab treatment was effective for both RP and psoriasis. Fat-suppressed contrast-enhanced magnetic resonance imaging was beneficial, not only to demonstrate subclinical inflammation in the nasal septum, but also to subjectively assess the improvement of RP.

Keywords: adalimumab; anti-type II collagen antibody; contrast-enhanced magnetic resonance imaging; psoriasis vulgaris; relapsing polychondritis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adalimumab / therapeutic use*
  • Administration, Cutaneous
  • Adult
  • Antirheumatic Agents / therapeutic use*
  • Autoantibodies / blood
  • Autoimmune Diseases / etiology
  • Biopsy
  • C-Reactive Protein / analysis
  • Cholecalciferol / therapeutic use
  • Collagen Type II / immunology
  • Ear Cartilage / diagnostic imaging
  • Ear Cartilage / immunology
  • Ear Cartilage / pathology
  • Glucocorticoids / therapeutic use*
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Matrix Metalloproteinase 3 / blood
  • Polychondritis, Relapsing / diagnostic imaging
  • Polychondritis, Relapsing / drug therapy*
  • Polychondritis, Relapsing / immunology
  • Polychondritis, Relapsing / pathology
  • Psoriasis / blood
  • Psoriasis / drug therapy*
  • Psoriasis / immunology
  • Severity of Illness Index

Substances

  • Antirheumatic Agents
  • Autoantibodies
  • Collagen Type II
  • Glucocorticoids
  • Cholecalciferol
  • C-Reactive Protein
  • MMP3 protein, human
  • Matrix Metalloproteinase 3
  • Adalimumab