TNF and Papule: The concept of anti-TNF-α inhibitor use introducing paradoxical psoriasis in patients is not a novel phenomenon.1, –3 Nonetheless, there are few reports detailing the development of linear psoriasis as a result of anti-TNF-α inhibitor use in the literature.4 Linear psoriasis is a rare presentation of psoriasis, characterized by erythematous plaques and/or papules following the lines of Blaschko in the absence of mid-line traversal.5 Given its rarity, uncertainty remains regarding its pathogenesis.