TNF inhibitor induced alopecia: an unusual form of psoriasiform alopecia that breaks the Renbök mold
Craddock, L.N.; Cooley, D.M.; Endo, J.O.; Longley, B.J.; Caldera, F.
Dermatology Online Journal 23(3)
2017
ISSN/ISBN: 1087-2108 PMID: 28329519 Document Number: 692284
TNF-α-inhibitors are known to induce skin adverseeffects including psoriasis and alopecia areata. Here, wedescribe a unique pattern of hair loss that has psoriaticand alopecia areata-like features. Diagnosis requiresclinical-pathologic correlation and is supportedby increased catagen/telogen hairs, psoriasiformepidermal hyperplasia, perifollicular lymphocyticinfiltrate, and the presence of eosinophils and plasmacells. Although there are no treatment consensusguidelines, management options include stoppingtherapy, switching to a different TNF-α inhibitor orustekinumab (in severe cases), or continuing TNF-αinhibitor therapy with addition of topical, intralesional,or systemic immunosuppressants.