Psoriatic Alopecia/Alopecia Areata–Like Reactions Secondary to Anti–Tumor Necrosis Factor-α Therapy: A Novel Cause of Noncicatricial Alopecia

    Leona A. Doyle, Leonard C. Sperling, Shashi Baksh, Jeffrey Lackey, Brian Thomas, Ruth Ann Vleugels, Abrar A. Qureshi, Elsa F. Velázquez
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    TLDR Anti-TNF therapy can cause a unique type of hair loss that may get better with topical treatments without stopping the therapy.
    The study from 2011 examined a new cause of noncicatricial alopecia in three female patients aged 21, 27, and 39, who developed scalp alopecia and, in two cases, psoriasiform skin lesions, while receiving anti-TNF therapy for Crohn's disease. Histopathological analysis of scalp and skin biopsies showed psoriasiform epidermal changes and alopecia areata-like dermal changes, including an inflammatory infiltrate with plasma cells and eosinophils. These findings suggest that anti-TNF therapy can induce alopecia that mimics psoriatic alopecia and alopecia areata but has distinct histological features. The study concluded that this type of alopecia may improve with topical treatments without discontinuing anti-TNF therapy, highlighting the importance of recognizing this condition for proper patient management.
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