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HPV: human papilloma virus HS: hidradenitis suppurativa RA: rheumatoid arthritis TNF: tumor necrosis factor INTRODUCTION Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting apocrine gland areas leading to recurrent abscesses and nodules, forming scars and sinus tracts. Adalimumab, a tumor necrosis factor (TNF)-a monoclonal antibody is the first treatment approved by the US Food and Drug Administration for HS. TNF-a plays a primary and critical role in themechanism of autoimmune disease by binding to TNF-a receptors, and initiating the immune response. Biological therapies have dramatically changed the management of chronic inflammatory skin disorders. The association between cervical dysplasia and TNF-a blocking therapy is well documented. TNF-a plays a critical role in the control of viral infection, including human papilloma virus (HPV). Therefore, the therapeutic TNF-a inhibition may increase the risk of HPV reactivation and lead to cervical dysplasia and carcinoma. We report, for the first time to our knowledge, the impressive case of an HS patient who went on to have a cervical epidermoid carcinoma 6 months after starting adalimumab therapy.

Occurrence of an invasive cervical epidermoid carcinoma in a patient receiving TNF-α blocking therapy for hidradenitis suppurativa