Alopecia Diffusa While Using Interleukin-17 Inhibitors Against Psoriasis Vulgaris

The document reported two cases of alopecia diffusa occurring during the treatment of psoriasis vulgaris with interleukin (IL)-17 inhibitors. Both patients, a 62-year-old female and a 40-year-old female, experienced significant hair loss after starting IL-17 inhibitor treatments (secukinumab and brodalumab, respectively). The hair loss was reversed in the first patient with the addition of oral prednisolone and in the second patient by switching to ustekinumab, an IL-12/23 p40 inhibitor. The study suggested that the paradoxical reaction of alopecia might be due to the conversion of the Th17/Th1 axis into a Th1-dominant immune status, leading to hair follicle destruction. The authors concluded that more cases need to be accumulated to understand this phenomenon better.