Nivolumab-Induced Alopecia Areata: A Case Report and Literature Review

A 55-year-old male developed alopecia areata (AA) after 6 months of nivolumab treatment for hepatocellular carcinoma, progressing to alopecia totalis despite treatment with triamcinolone and minoxidil. Histopathology confirmed AA with decreased hair follicles and lymphocytic infiltration. The case suggested that nivolumab, an immune checkpoint inhibitor, can induce AA as a rare side effect, likely due to immune-related adverse events, though the exact pathogenesis remains unclear. Further research was needed to understand the mechanisms and improve management of such side effects.