Tumor Necrosis Factor-Alpha Inhibitor Associated Psoriasiform Alopecia

April 2012 in “ Informa Healthcare eBooks ”

Tumor Necrosis Factor-alpha Inhibitor psoriasiform alopecia TNF-alpha inhibitors psoriasiform scalp plaques hair loss topical steroids intralesional triamcinolone catagen phase telogen phase sebaceous glands peribulbar inflammation plasma cells steroids triamcinolone

TLDR Some medications for inflammation can cause a condition with scalp rashes and hair loss, often linked to Crohn's disease, and may require treatment changes to prevent permanent hair loss.

The document from 2012 discusses Tumor Necrosis Factor-alpha Inhibitor Associated Psoriasiform Alopecia (TAIAPA), a condition that manifests in patients undergoing treatment with TNF-alpha inhibitors, which can cause paradoxical psoriasiform skin reactions. TAIAPA is marked by psoriasiform scalp plaques and hair loss, with a distinct histopathological pattern. The suspected cause is an imbalance between TNF-alpha and interferon-alpha due to TNF-alpha inhibition. Reported in both adults and children, it is often associated with Crohn's disease. Treatments include topical steroids, intralesional triamcinolone, and sometimes stopping the TNF-alpha inhibitor. Histologically, TAIAPA presents with more inflammation than psoriatic alopecia, numerous hairs in the catagen/telogen phase, reduced sebaceous glands, and peribulbar inflammation with plasma cells. The document highlights the importance of recognizing TAIAPA, particularly in children, to avoid misdiagnosis and delayed treatment that could result in permanent alopecia.

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