Alopecia Universalis Under Adalimumab Therapy in a Patient with Rheumatoid Arthritis

A 56-year-old female patient with rheumatoid arthritis developed alopecia universalis, a complete loss of hair, during treatment with the TNF-α inhibitor adalimumab. Despite discontinuing adalimumab, her alopecia did not improve. The study suggested that interferon-α might play a key role in the inflammation process leading to hair loss after TNF-α inhibition. The risk/benefit ratio of continuing or stopping TNF inhibitors should be carefully considered when alopecia occurs during treatment.