Onset of Frontal Fibrosing Alopecia During Inhibition of Th1/17 Pathways with Ustekinumab

January 2019 in “ Dermatology Online Journal ”

Andrew King, Lauren Lam, Carolyn Goh

TLDR Ustekinumab treatment didn't prevent frontal fibrosing alopecia.

A 62-year-old woman developed frontal fibrosing alopecia (FFA) while being treated with ustekinumab for psoriasis, suggesting that the Th1 and Th17 pathways, as well as IL-12 and IL-23 inhibition, were not essential in the pathogenesis of FFA. This case provided evidence against the effectiveness of targeting these pathways for treating this form of scarring alopecia.

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Research cited in this study

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research Frontal Fibrosing Alopecia: Reflections and Hypotheses on Etiology and Pathogenesis

68 citations , May 2016 in “Experimental dermatology”

FFA's causes may include environmental triggers and genetic factors.

research Lichen Planopilaris Is Characterized By Immune Privilege Collapse Of The Hair Follicle's Epithelial Stem Cell Niche

220 citations , June 2013 in “The Journal of Pathology”

Lichen planopilaris may be an autoimmune disease causing hair loss due to immune system issues in hair follicles.

research Treatment of Frontal Fibrosing Alopecia and Lichen Planopilaris: A Systematic Review

117 citations , March 2013 in “Journal of the European Academy of Dermatology and Venereology”

No effective treatment for frontal fibrosing alopecia was found, but oral 5-alpha-reductase inhibitors had the best response; for lichen planopilaris, topical corticosteroids were commonly used but had a high relapse rate.

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