Bilateral Osteonecrosis of the Femoral Head Associated with Corticosteroid Therapy for Alopecia Areata: A Case Report and Review of the Literature

August 2018 in “ Therapeutics and Clinical Risk Management ”

Yutaka Kuroda, Toshiyuki Kawai, Koji Goto, Shuichi Matsuda

alopecia areata corticosteroid therapy osteonecrosis of the femoral head total hip arthroplasty joint-preserving surgery MRI femoral head collapse AA ONFH

TLDR Corticosteroid therapy for alopecia areata can cause severe hip bone damage.

A 23-year-old woman developed bilateral osteonecrosis of the femoral head (ONFH) after receiving corticosteroid therapy for alopecia areata (AA). Despite various treatments, including high-dose corticosteroids, her AA progressed, leading to ONFH, diagnosed as stage three postcollapse on the right and stage one precollapse on the left. She underwent total hip arthroplasty for the right hip and joint-preserving surgery for the left. This case underscored the severe risk of ONFH with corticosteroid use, emphasizing the need for early detection through MRI and careful monitoring to prevent femoral head collapse. The findings highlighted the importance of weighing the benefits and risks of corticosteroid therapy in treating AA.

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Research cited in this study

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research Alopecia Areata: An Autoimmune Disease Causing Hair Loss

421 citations, April 2012 in “The New England Journal of Medicine”

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Current treatments for alopecia show no significant long-term benefits.

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