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Acitretin + adalimumab is a combination therapy consisting of acitretin, an oral retinoid, and adalimumab, a monoclonal antibody targeting tumor necrosis factor-alpha (TNF-α). This combination is primarily used off-label for the treatment of moderate to severe or refractory psoriasis, including generalized pustular psoriasis. Acitretin modulates keratinocyte differentiation and proliferation through activation of retinoic acid receptors, while adalimumab inhibits TNF-α-mediated inflammatory pathways. The combination has shown synergistic effects in improving skin lesions and controlling disease activity in patients unresponsive to monotherapy. Clinical reports indicate rapid improvement and sustained remission with acceptable tolerability; however, long-term safety data are limited[1][2][3][4].
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