Simultaneous HBV Reactivation and Hair Discoloration Under Secukinumab Treatment

A 36-year-old male with psoriasis experienced simultaneous hepatitis B virus (HBV) reactivation and hair discoloration while undergoing secukinumab treatment. Despite negative hepatitis B surface antigen (Hbs Ag) and normal liver transaminase levels, HBV-DNA PCR became positive in the second year of treatment. The patient also noted reddish hair discoloration, which had not been previously reported with secukinumab. Entecavir treatment was initiated, leading to negative HBV-DNA PCR results after three months, though hair discoloration persisted. This case suggests that HBV reactivation can occur without Hbs Ag positivity and highlights the importance of regular HBV-DNA PCR monitoring in patients with Anti-Hbc IgG positivity. The link between hair discoloration and HBV infection may be coincidental or indicative of viral reactivation, warranting further investigation.