Treatment of coincident seronegative arthritis and hidradentis supprativa with adalimumab.

In this case, a 41-year-old morbidly obese African American male with arthritis, hidradentitis suprativa, and a history of cystic acne with keloid formation was treated with adalimumab. The patient had developed hidradentitis 15 years before presentation and arthritis 8 years before presentation. He had a history of nodules and ulcers on his legs clinically diagnosed as pyoderma gangrenosum. He complained of frequent bowel movements that did not, upon investigation, relate to infection or inflammatory bowel disease. For the 6 months leading up to his consultation, he had been treated with 600 mg of hydroxychloroquine, isotretinoin 40 mg trice daily (120 mg/d), and 10 mg of methotrexate dosed every 12 hours in 3 doses weekly (30 mg/ wk) without effect.