Figure 1. A-B. Cutaneous manifestations of the patient was noted by erythema and scales on his trunk and limbs. C-D. Cutaneous manifestations 8weeks after starting adalimumab. E-F (Hematoxylin & Eosin stain, E:40×magnification; F:200×magnification). Skin biopsy was characterized by a greatly thickened epidermis with elongation of the rete ridges that protrude down into the dermis. There is retention of keratinocyte nuclei in the outer layers. These dermal blood vessels and surrounding upper dermal spaces are filled with predominantly mononuclear leukocytes and neutrophils.