Adalimumab-Induced Scalp Psoriasis with Severe Alopecia

August 2019 in “ Dermatologic therapy ”

Ezgi Özkur, İlknur Kivanç Altunay, Cem Leblebıcı, Zeynep Topkarcı, Yasemin Erdem

adalimumab scalp psoriasis alopecia palmoplantar pustulosis chronic plaque psoriasis methotrexate psoriasiform changes anti-TNF-α topical adjuvant agents scarring alopecia Humira hair loss skin lesions topical treatments

TLDR Stopping adalimumab and starting methotrexate with topical treatments improved the woman's scalp psoriasis and hair regrew.

In a case reported in 2019, a 37-year-old woman developed palmoplantar pustulosis and scalp psoriasis with severe alopecia after being treated with adalimumab for chronic plaque psoriasis for two months. Biopsies from her palmar and scalp lesions indicated psoriasiform changes. Following the discontinuation of adalimumab, the patient was treated with methotrexate (15 mg/weekly, subcutaneously) along with topical adjuvant agents. This treatment led to a dramatic improvement in her skin and scalp conditions, with complete hair regrowth observed within one month. The study suggests that for anti-TNF-α-induced scalp psoriasis, it is beneficial to suspend the anti-TNF-α agent and apply systemic and topical treatments to prevent scarring alopecia. The authors declare no potential conflict of interest.

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Adalimumab-Induced Scalp Psoriasis with Severe Alopecia

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