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Severe Infliximab-Induced Alopecia and Scalp Psoriasis in a Woman with Crohn ’ s Disease: Dramatic Improvement after Drug Discontinuation and Treatment with Adjuvant Systemic and Topical Therapies

View Article: PubMed Central - PubMed

ABSTRACT

Scalp psoriasis with alopecia is a rare cutaneous reaction to tumor necrosis factor alpha antagonists. This reaction often reverses with discontinuation of the offending drug and initiation of topical treatments; however, irreversible hair loss may occur if a scarring alopecia develops. We describe a woman with Crohn’s disease who developed scalp psoriasis and alopecia secondary to infliximab. She had a remarkable recovery after discontinuation of infliximab and treatment with oral minocycline and topical therapy: mineral oil under occlusion, betamethasone lotion, and sequential coal tar, salicylic acid, and ketoconazole shampoos each day. The patient’s alopecia completely resolved within 4 months of initiating this treatment regimen. In summary, early diagnosis of alopecia secondary to tumor necrosis factor alpha antagonist therapy is crucial in preventing diffuse alopecia and scalp psoriasis. In addition to discontinuing the offending agent, initiating aggressive adjuvant treatment with an oral antibiotic, topical therapies, or both, should be considered to reverse tumor necrosis factor alpha antagonist-induced alopecia and/or scalp psoriasis.

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Related in: MedlinePlus

Distant (a) and closer (b) images of the patient’s hair and scalp. The patient’s alopecia had completely resolved at her 4-month follow-up visit (a). Small areas with shorter hair, representing new hair growth, are seen (b)
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Fig3: Distant (a) and closer (b) images of the patient’s hair and scalp. The patient’s alopecia had completely resolved at her 4-month follow-up visit (a). Small areas with shorter hair, representing new hair growth, are seen (b)

Mentions: The patient’s alopecia and scalp psoriasis both remarkably improved. Indeed, at her 4-month follow-up visit there were no scalp scales and all of her hair had returned (Fig. 3). Her topical scalp therapies were tapered and subsequently discontinued. Neither her alopecia nor scalp psoriasis recurred.Fig. 3


Severe Infliximab-Induced Alopecia and Scalp Psoriasis in a Woman with Crohn ’ s Disease: Dramatic Improvement after Drug Discontinuation and Treatment with Adjuvant Systemic and Topical Therapies
Distant (a) and closer (b) images of the patient’s hair and scalp. The patient’s alopecia had completely resolved at her 4-month follow-up visit (a). Small areas with shorter hair, representing new hair growth, are seen (b)
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5120642&req=5

Fig3: Distant (a) and closer (b) images of the patient’s hair and scalp. The patient’s alopecia had completely resolved at her 4-month follow-up visit (a). Small areas with shorter hair, representing new hair growth, are seen (b)
Mentions: The patient’s alopecia and scalp psoriasis both remarkably improved. Indeed, at her 4-month follow-up visit there were no scalp scales and all of her hair had returned (Fig. 3). Her topical scalp therapies were tapered and subsequently discontinued. Neither her alopecia nor scalp psoriasis recurred.Fig. 3

View Article: PubMed Central - PubMed

ABSTRACT

Scalp psoriasis with alopecia is a rare cutaneous reaction to tumor necrosis factor alpha antagonists. This reaction often reverses with discontinuation of the offending drug and initiation of topical treatments; however, irreversible hair loss may occur if a scarring alopecia develops. We describe a woman with Crohn’s disease who developed scalp psoriasis and alopecia secondary to infliximab. She had a remarkable recovery after discontinuation of infliximab and treatment with oral minocycline and topical therapy: mineral oil under occlusion, betamethasone lotion, and sequential coal tar, salicylic acid, and ketoconazole shampoos each day. The patient’s alopecia completely resolved within 4 months of initiating this treatment regimen. In summary, early diagnosis of alopecia secondary to tumor necrosis factor alpha antagonist therapy is crucial in preventing diffuse alopecia and scalp psoriasis. In addition to discontinuing the offending agent, initiating aggressive adjuvant treatment with an oral antibiotic, topical therapies, or both, should be considered to reverse tumor necrosis factor alpha antagonist-induced alopecia and/or scalp psoriasis.

No MeSH data available.


Related in: MedlinePlus