Psoriatic Alopecia in a Patient With Crohn's Disease: An Uncommon Manifestation of Tumor Necrosis Factor Alpha Inhibitors

In 2021, a case was reported of a 12-year-old girl with Crohn disease who developed psoriatic alopecia after her dose of adalimumab, a TNF-α inhibitor, was increased. This condition emerged 6 months following the dosage change. Upon investigation, including biopsies and cultures, the alopecia was diagnosed as secondary to the TNF-α inhibitor. A review of the literature identified an additional 24 cases with similar symptoms, of which only 6 were pediatric patients. TNF-α inhibitors, which are approved for various inflammatory conditions, have been known to cause paradoxical psoriasis as a side effect, with severe scalp involvement leading to alopecia in 7.5% of cases. This phenomenon is becoming more common as these medications are increasingly used in the pediatric population for nondermatologic conditions. The case adds to a small but growing number of reported instances of TNF-α inhibitor-induced psoriatic alopecia in children.