Alopecia Areata in a Patient with Psoriatic Arthritis and Crohn's Disease Receiving Etanercept

This case report described a woman with Crohn's disease and psoriatic arthritis who developed alopecia areata after starting treatment with etanercept, a TNF-α blocker. Despite the known role of TNF-α in inhibiting hair follicle growth, the literature on the relationship between TNF-α blockers and alopecia areata was conflicting. The patient experienced significant improvement in arthritis and psoriasis symptoms with etanercept, but alopecia areata developed, leading to the discontinuation of etanercept. Her scalp hair fully healed after 6 months on sulfasalazine alone. The report highlighted the complex role of TNF-α in alopecia areata pathogenesis and suggested that different TNF-α blockers might have varying effects on the cytokine network, as alopecia was not observed with infliximab and adalimumab.