Dual efficacy of dupilumab in a patient with concomitant atopic dermatitis and alopecia areata

Dupilumab and alopecia: A Janus effect

“…All these subjects had been refractory to treatment for AA with topical steroids and systemic Cy, methotrexate, or prednisone. Hair regrowth occurred in all the patients on the scalp between 2 and 8 months after starting D (Alniemi & McGevna, ; Darrigade et al, ; Dobkin et al, ; Penzi et al, ; Sevray et al, ; Smogorzewski et al, ; Uchida et al, ). In two cases of AU, hair regrowth of eyebrow, axillary, and pubic hair growth was also observed (Darrigade et al, ; Smogorzewski et al, ).…”

“…Hair regrowth occurred in all the patients on the scalp between 2 and 8 months after starting D (Alniemi & McGevna, ; Darrigade et al, ; Dobkin et al, ; Penzi et al, ; Sevray et al, ; Smogorzewski et al, ; Uchida et al, ). In two cases of AU, hair regrowth of eyebrow, axillary, and pubic hair growth was also observed (Darrigade et al, ; Smogorzewski et al, ). However, five cases of AA development after the beginning of D treatment were reported (Table ) (Barroso‐García et al, ; Flanagan et al, ; Kanda et al, ; Mitchell & Levitt, ; Salgüero‐Fernández et al, ).…”

Improvement of alopecia areata with Dupilumab in a patient with severe atopic dermatitis and review the literature

“…Although the evidence supports the involvement of a Th1‐mediated immune response in the pathogenesis of AA, polymorphisms in IL‐4 and IL13 have recently been discovered in these patients. An increased expression of genes related to the Th2 response has been observed in skin biopsies from patients with AA . In addition, some cases of hair growth in patients with AA after dupilumab treatment have been reported.…”

Dupilumab and Alopecia: Causative or Therapeutic?

“…These conflicting clinical observations are mirrored in a number of recent case reports. Our literature review yielded 6 recent case reports on “dupilumab” and “alopecia,” with 4 describing alopecia developing after initiation of dupilumab [1-4] and 2 reporting resolution of pre-existing alopecia [5, 6]. …”

“…Given this association, an ongoing phase II trial is evaluating the benefit and safety of dupilumab in AA in patients with and without concomitant AD [9]. Case reports of pre-existing alopecia resolving with dupilumab therapy for concomitant AD describe a patient with a 1-year history of focal AA progressing to universalis [5] and a patient with an 11-year history of alopecia totalis [6], both previously refractory to systemic treatment with methotrexate, cyclosporine and prednisone. Hair regrowth was observed 6 weeks to 3 months after starting dupilumab, with near complete resolution of alopecia by 6–11 months.…”