Alopecia areata following adalimumab.
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.
Kirshen
Carly
C
Department of Dermatology, University of Ottawa, Ottawa, ON. carly.kirshen@learnlink.mcmaster.ca
Kanigsberg
Nordau
N
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*
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab