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In this case report, a patient with Crohn's disease experienced alopecia and psoriasiform reactions attributed to anti-TNF therapy, which improved after switching to Ustekinumab.

In this study, nearly 5% of anti-TNF-treated patients with IBD developed psoriasiform skin lesions, with smoking identified as a main risk factor, and ustekinumab proved highly effective in severe cases.

This study found that anti-TNF therapy-induced alopecia exhibits distinct clinical and histopathological features and can mimic psoriatic alopecia and alopecia areata, with some patients improving with topical treatment.

In this study, only 1 out of 5 patients with anti-TNF-α induced psoriasiform eruptions showed good response to topical treatment, while systemic therapy and discontinuation of anti-TNF-α may prevent scarring alopecia in severe cases.

This case series highlights that anti-TNF agents, though beneficial for autoimmune conditions, can cause a rare adverse reaction of psoriasiform alopecia areata, stressing the importance of specific histopathological features for accurate diagnosis and better management to avoid unnecessary drug discontinuation.