In psoriasis, a specific cytokine network has been described to play a central 
role in the pathophysiology of the disease. Anti-cytokine therapeutic approaches 
have been largely developed and TNFα constitutes the main target. Adalimumab is 
a human anti-TNFα monoclonal antibody that has been reported to demonstrate 
clinical efficacy and safety, resulting in reversal of epidermal hyperplasia and 
cutaneous inflammation. We aimed to analyse changes in the skin inflammatory 
transcriptomic profile in psoriatic patients during adalimumab therapy. In 
addition, the circulating cytokine profile was analysed to define systemic 
inflammation. Eighteen patients with chronic plaque psoriasis were treated with 
adalimumab. After four and 16 weeks, clinical efficacy was assessed using PASI 
and DLQI, and skin mRNA profiles were determined and circulating cytokines 
quantified. We identified a rapid effect of adalimumab therapy on a large array 
of Th17 cytokines of the skin, which may account for the modification of 
keratinocyte expression profile and clinical response. In contrast, analysis of 
serum cytokine concentrations was uninformative, confirming the need for 
characterization of local cytokines in skin lesions. Finally, in non-responders, 
local cytokine expression was shown to be unchanged. We show that TNFα 
inhibition in psoriasis patients treated with adalimumab has a broad effect on 
the expression profile of cytokines and keratinocyte markers of skin 
inflammation, which may account for its clinical efficacy.