Simultaneous Bullous Pemphigoid and Vitiligo Associated with Adalimumab Therapy in a Patient with Psoriasis Vulgaris

Antitumor necrosis factors (TNFs) agents are increasingly being used for the effective treatment of diverse diseases. Due to its extensive use and longer duartion of treatment, there are a growing number of reports of the development of autoimmune conditions such as systemic lupus erythematosus, bullous pemphigoid (BP), and vitiligo associated with the use of anti-TNF agents. We describe a patient who developed BP as well as vitiligo after receiving treatment with adalimumab for plaque psoriasis. To our knowledge, this is the first case of simultaneous presentation of two diseases related to the use of adalimumab, and this highlights the importance of monitoring for more than one autoimmune event during TNF inhibition treatment.