Azathioprine-Induced Agranulocytosis and Severe Alopecia After Kidney Transplantation Associated With a NUDT15 Polymorphism: A Case Report

A 27-year-old male with diffuse hair loss, including the donor area, did not respond to finasteride, dutasteride, or minoxidil. He suspects his hair loss may be linked to a mild connective tissue disorder, possibly affecting the structural support of hair follicles, rather than being purely hormonal.

The user increased their steroid dosage and noticed hair shedding, so they adjusted their regimen by reducing steroid doses and adding oral dutasteride. They are also experimenting with combining RU-58841 and KX-826/pyrilutamide in minoxidil to address hair loss.

The user is experiencing diffuse thinning and inflammation despite using 2.5mg dutasteride daily, ciclopirox, and ketoconazole shampoos. They are considering treatments like hydroxychloroquine and JAK inhibitors due to suspected scarring alopecia and have faced challenges in obtaining a scalp biopsy.

An arthritis drug restored significant hair in people with alopecia areata, but it is not effective for male pattern baldness. The drug, Upadacitinib, has serious side effects and is expensive.

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

The user is considering starting pyrilutamide before a scheduled hair transplant, having previously used oral minoxidil and finasteride with worsening results. They also tried dutasteride, which worsened their hair and made their skin oily.