Alopecia Universalis After Discontinuation of Pegylated Interferon and Ribavirin Combination Therapy for Hepatitis C: A Case Report

In 2014, a 49-year-old male patient developed alopecia universalis, a complete loss of hair on the scalp and body, after stopping a 12-week treatment with pegylated interferon and ribavirin for chronic hepatitis C. The hair loss started one month after the end of treatment and progressed to total hair loss within three months. Attempts to treat the condition with topical corticosteroids and heliotherapy were unsuccessful. A scalp biopsy conducted 13 months after treatment cessation showed no terminal hair follicles and a moderate perifollicular lymphocytic infiltration, indicating an irreversible condition. This case underscores the importance of physicians being aware of and communicating the potential for adverse effects, including those that may arise after the discontinuation of interferon-based therapy for hepatitis C. The report also suggests that interferon-free treatments might prevent such autoimmune side effects.