title: Alopecia areata following adalimumab.
abstract: BACKGROUND
  Alopecia areata is a nonscarring hair loss characterized by well-circumscribed patchy areas, most often on the scalp. The inflammatory cytokine tumor necrosis factor alpha (TNF-alpha), has been connected with the development of alopecia areata in vivo; thus, the TNF-alpha inhibitors have been cited as possible treatments for this autoimmune condition.
  
  
  OBJECTIVE
  We report a case of alopecia areata that developed in a 52-year-old woman who was recently started on adalimumab for treatment of her psoriatic arthritis.
  
  
  RESULTS
  We discuss the previously published cases in the literature linking alopecia areata to TNF-alpha inhibitor administration. Our case is the first report of a new-onset alopecia areata following adalimumab.
  
  
  CONCLUSIONS
  Even though TNF-alpha is implicated in causing alopecia areata, TNF-alpha inhibitors have paradoxically been associated with new cases of alopecia areata. It is possible that TNF-alpha may not be involved in the pathogenesis of alopecia areata, as in vitro studies have suggested.
authors.affiliation: Department of Dermatology, University of Ottawa, Ottawa, ON. carly.kirshen@learnlink.mcmaster.ca
authors.forename: Carly
authors.initials: C
authors.lastname: Kirshen
authors.forename: Nordau
authors.initials: N
authors.lastname: Kanigsberg
mesh_terms: D000068879:Adalimumab; D000506:Alopecia Areata / Q000139:chemically induced* / Q000276:immunology; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D015535:Arthritis, Psoriatic / Q000188:drug therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab