Alopecia Areata as Another Immune-Mediated Disease Developed in Patients Treated with Tumor Necrosis Factor-Alpha Blocker Agents

The study aimed to characterize alopecia areata (AA) that developed during anti-TNF-α therapy, presenting five new cases and reviewing eleven reported cases. One third of the cases had a personal or family history of AA, with most experiencing rapid and extensive AA, often involving the ophiasis area. The prognosis was generally poor, with minimal response to treatments, and the course of AA did not change when anti-TNF-α therapy was continued. The findings suggested that AA might be more common during anti-TNF-α therapy than previously thought, and a history of autoimmune disease could indicate a higher risk of developing or relapsing AA with this treatment.