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Paradoxical adverse reactions to tumor necrosis (TNF)\u2010alpha inhibitors have been reported, and rare cutaneous complications include pyoderma gangrenosum, Sweet syndrome\u2010like hypersensitivity eruptions, and pustular folliculitis. We report an unusual case of AF in a patient with Crohn disease that worsened with doses of adalimumab, which is considered a second\u2010line treatment for AF. This case highlights that acneiform eruptions may be an underreported paradoxical adverse reaction to anti\u2010TNF alpha therapy.<\/jats:p>","DOI":"10.1111\/pde.15226","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T10:36:08Z","timestamp":1672137368000},"page":"678-680","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Tumor necrosis factor\u2010alpha inhibitors and acne fulminans: Friend or foe?"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0382-4470","authenticated-orcid":false,"given":"Kelly K.","family":"Barry","sequence":"first","affiliation":[{"name":"Department of Dermatology, Massachusetts General Hospital Harvard Medical School  Boston Massachusetts USA"},{"name":"Tufts University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0361-3657","authenticated-orcid":false,"given":"Holly D.","family":"Neale","sequence":"additional","affiliation":[{"name":"University of Massachusetts Medical School  Worcester Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-3339","authenticated-orcid":false,"given":"Elena B.","family":"Hawryluk","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Massachusetts General Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,27]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.11.028"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.23736\/s0392\u20100488.20.06711\u20105"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.6678"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1203475420917387"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100560.2012.01894.x"},{"issue":"1","key":"e_1_2_5_7_1","first-page":"31","article-title":"Etanercept\u2010induced cystic acne","volume":"94","author":"Kashat M","year":"2014","journal-title":"Cutis"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546630802155073"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12416"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2017.2990"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102133.2007.08172.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102133.2006.07665.x"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.15226","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pde.15226","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.15226","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T05:38:49Z","timestamp":1692337129000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.15226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,27]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/pde.15226"],"URL":"https:\/\/doi.org\/10.1111\/pde.15226","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"type":"print","value":"0736-8046"},{"type":"electronic","value":"1525-1470"}],"subject":[],"published":{"date-parts":[[2022,12,27]]},"assertion":[{"value":"2022-09-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}