Reactions 1477, p5 - 9 Nov 2013 Adalimumab/etanercept Alopecia areata: case report A 50-year-old man, who had a history of psoriasis and psoriatic arthritis, developed alopecia areata during treatment with etanercept; when etanercept was switched to adalimumab, his hair loss continued to worsen. The man, whose medical history also included type 2 diabetes mellitus and gout, began receiving etanercept [dosage and route not stated]. His psoriasis improved but, 9 months after starting etanercept, he developed localised, sharply demarcated, circular patches of hair loss over the front and parietal scalp along with his midline beard. The base of the lesions was smooth and there was no scarring or atrophy. The man’s etanercept was switched to adalimumab [dosage and route not stated] for better management of his psoriatic arthritis and he received topical fluocinonide gel and desonide cream to the scalp and beard, respectively. However, his hair loss continued to enlarge progressively to near-complete alopecia universalis. Four months after all tumor necrosis factor-α (TNF-α) inhibitors were stopped, his alopecia persisted. Concomitant medications were insulin glargine, liraglutide, glipizide, metformin, simvastatin and fenofibrate. Author comment: "[I]nduction of alopecia areata may be a class-wide adverse effect for all TNF-α antagonists." Griffith JL, et al. Tumor necrosis factor-alpha antagonists and alopecia areata: A class-wide adverse effect. Journal of Drugs in Dermatology 12: 713-714, No. 6, Jun 2013 - USA 803095400 1 Reactions 9 Nov 2013 No. 1477 0114-9954/13/1477-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved

Adalimumab/etanercept

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Reactions 1477, p5 - 9 Nov 2013

Adalimumab/etanercept

Alopecia areata: case reportA 50-year-old man, who had a history of psoriasis and

psoriatic arthritis, developed alopecia areata during treatmentwith etanercept; when etanercept was switched toadalimumab, his hair loss continued to worsen.

The man, whose medical history also included type 2diabetes mellitus and gout, began receiving etanercept [dosageand route not stated]. His psoriasis improved but, 9 monthsafter starting etanercept, he developed localised, sharplydemarcated, circular patches of hair loss over the front andparietal scalp along with his midline beard. The base of thelesions was smooth and there was no scarring or atrophy.

The man’s etanercept was switched to adalimumab [dosageand route not stated] for better management of his psoriaticarthritis and he received topical fluocinonide gel and desonidecream to the scalp and beard, respectively. However, his hairloss continued to enlarge progressively to near-completealopecia universalis. Four months after all tumor necrosisfactor-α (TNF-α) inhibitors were stopped, his alopeciapersisted. Concomitant medications were insulin glargine,liraglutide, glipizide, metformin, simvastatin and fenofibrate.

Author comment: "[I]nduction of alopecia areata may be aclass-wide adverse effect for all TNF-α antagonists."Griffith JL, et al. Tumor necrosis factor-alpha antagonists and alopecia areata: Aclass-wide adverse effect. Journal of Drugs in Dermatology 12: 713-714, No. 6,Jun 2013 - USA 803095400