This might be the case with the two patients reported by Hall and Zimmermann and Liozon et al., as initially affected by RA, where the definite diagnosis after the introduction of the anti-TNF-α agent was undifferentiated overlap syndrome with features of polyarthritis, myositis, and scleroderma (dactylitis), possibly induced or exacerbated by adalimumab and in the second patient a clear diagnosis of DM probably without RA [18, 19]. The gene discussed is TNF; the disease is scleroderma.