Alopecia Areata in Severe Atopic Dermatitis Treated With Dupilumab

The document described a case of a 31-year-old man with severe atopic dermatitis (AD) who developed alopecia areata after being treated with dupilumab, a monoclonal antibody targeting interleukin-4 receptor alpha. Despite significant improvement in AD symptoms, the patient experienced patchy hair loss on the scalp within 6 weeks of starting dupilumab. This was the first biopsy-confirmed case of alopecia areata associated with dupilumab treatment in severe AD. The pathogenesis of alopecia areata was not fully understood, but it was suggested that the downregulation of TH2 pathways by dupilumab might amplify the TH1 pathway, potentially leading to alopecia areata. Although clinical trials of dupilumab had not previously reported alopecia areata as an adverse effect, this case highlighted the need for clinicians to be aware of this potential association.