Abstract: 【Abstract】 Objective To evaluate the efficacy and safety of adalimumab in the treatment of severe plaque psoriasis. Methods From June 2018 to April 2019, 20 patients with severe plaque psoriasis were collected from Department of Dermatology, Henan Provincial People′s Hospital. After initial subcutaneous injection of adalimumab at a dose of 80 mg, these patients were subcutaneously injected with adalimumab at a dose of 40 mg at weeks 1, 3, 5, 7, 9 and 11. At weeks 4, 8 and 12, psoriasis area and severity index （PASI） was recorded, and changes in skin lesions were observed by reflectance confocal microscopy （RCM）. Adverse reactions were monitored during treatment. Results At week 4, 12 patients achieved a 50% reduction in PASI （PASI50）; at week 8, 14 achieved PASI75; at week 12, 20 patients achieved PASI75, of which 5 achieved PASI90 and 2 achieved PASI100. As RCM showed, the melanin content in the basal layer of skin lesions was lower compared with that of perilesional normal skin before treatment,gradually increased at week 4, and nearly returned to normal at week 12. No infections, tumors or other related adverse reactions occurred in the 20 patients. Conclusion Subcutaneous injection of adalimumab every other week is markedly effective in the treatment of severe psoriasis, with few related adverse reactions.

Key words: Psoriasis, Tumor necrosis factor-alpha, Antibodies, monoclonal, Treatment outcome, Drug toxicity, Adalimumab