Localized Interferon Alfa-2b-Induced Alopecia

Lang, A.; Norland, Ann M.; Schuneman, Rachel L.; Tope, Whitney D.

doi:10.1001/archderm.135.9.1126

Cited by 30 publications

(15 citation statements)

References 4 publications

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“…It is of interest that an improvement of telogen hair count was observed in 2 of these cases despite continuation of interferon as observed in 2 of our patients. Depilation, previously reported in rare cases, has never been observed in our series [7]. Hair whitening was present in 18% of our patients contrasting with rare reports in the literature [8, 9].…”

Section: Discussioncontrasting

confidence: 83%

A Prospective Study of Cutaneous Adverse Events Induced by Low-Dose Alpha-Interferon Treatment for Malignant Melanoma

et al. 2004

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Introduction: α-Interferon is associated with numerous cutaneous side effects, but the accurate incidence of these complications is not clearly known. Objectives: A prospective study was designed to evaluate the incidence and clinical pattern of cutaneous side effects in a cohort of patients receiving adjuvant therapy with low-dose interferon for malignant melanoma. Material and Methods: A cohort of 33 patients with stage IIA and IIB melanoma treated with low-dose α-interferon (3 MIU 3 times a week for 18 months) were prospectively enrolled in a single-center study. The patients responded to a questionnaire on their medical history and were systematically examined for any cutaneous lesions before treatment and every 3 months afterwards. Results: 29/33 patients (87%) experienced 1 or more cutaneous side effects. The most frequent was hair loss and occurred in 16 cases (48.4%). Hair discoloration was noted in 6 cases (18%). Eczematous reactions at injection sites or at remote sites were observed in 13 patients (39%). Pruritus occurred in 10 cases (30%). Xerostomia, Raynaud’s phenomenon or livedo reticularis were observed in 10 patients, associated with an increase in circulating autoantibody titer in 2 cases. Some rare side effects were observed: urticaria (1 case) or angioedema (1 case), worsening of preexisting seborrheic dermatitis (3 cases), herpetic recurrence (2 cases), pityriasis versicolor (1 case), worsening of recurrent buccal aphthous ulcer (1 case) and vitiligo (1 case). Conclusion: Cutaneous adverse events during adjuvant immunotherapy of melanoma with low-dose α-interferon seem to be frequent but do not result in treatment discontinuation. A good awareness of these side effects may be useful for a more accurate survey and clinical management of patients receiving this treatment.

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Section: Discussioncontrasting

confidence: 83%

A Prospective Study of Cutaneous Adverse Events Induced by Low-Dose Alpha-Interferon Treatment for Malignant Melanoma

et al. 2004

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“…Vasculitis is mostly cutaneous but can be systemic if severe Porphyria cutanea tarda [3,6] Most common viral infection associated with PCT. Prevalence of HCV infection in PCT cases varies geographically Lichen planus [7] Strongly correlated with HCV infection in meta-analysis Localized reactions Erythematous or eczematous dermatitis and psoriasis [16,19] Localized alopecia associated with local cutaneous reactions to interferon [20] Skin ulceration and necrosis [21] Local infections and local allergic reactions to interferon injection [16] Generalized reactions Alopecia/hair growth anomalies [16] Skin xerosis, dermatitis and pruritus [16,22] skin, such as lichen planus or psoriasis, Chronic inflammatory diseases of the which may be induced or exacerbated by interferon [16,19] Autoimmune disorders and immune-mediated inflammatory disease (e.g. psoriasis and sarcoidosis) [23,24] 1.62, 95% CI 1.29-2.02), and rash (RR 1.74, 95%CI 1.17-2.61), as demonstrated in a recent Cochrane meta-analysis [25].…”

Section: Dermatological Adverse Events On Peginterferon/ribavirinbasementioning

confidence: 99%

Dermatological side effects of hepatitis C and its treatment: Patient management in the era of direct-acting antivirals

Cacoub¹,

Bourlière²,

Lübbe³

et al. 2012

Journal of Hepatology

133

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Dermatological adverse events (AEs) are an existing concern during hepatitis C virus (HCV) infection and peginterferon/ribavirin treatment. HCV infection leads to dermatological and muco-cutaneous manifestations including small-vessel vasculitis as part of the mixed cryoglobulinemic syndrome. Peginterferon/ribavirin treatment is associated with well-characterized dermatological AEs tending towards a uniform entity of dermatitis. New direct-acting antivirals have led to significant improvements in sustained virologic response rates, but several have led to an increase in dermatological AEs versus peginterferon/ribavirin alone. In telaprevir trials, approximately half of treated patients had rash. More than 90% of these events were Grade 1 or 2 (mild/moderate) and in the majority (92%) of cases, progression to a more severe grade did not occur. In a small number of cases (6%), rash led to telaprevir discontinuation, whereupon symptoms commonly resolved. Dermatological AEs with telaprevir-based triple therapy were generally similar to those observed with peginterferon/ribavirin (xerosis, pruritus, and eczema). A few cases were classified as severe cutaneous adverse reaction (SCAR), also referred to as serious skin reactions, a group of rare conditions that are potentially life-threatening. It is therefore important to distinguish between telaprevir-related dermatitis and SCAR. The telaprevir prescribing information does not require telaprevir discontinuation for Grade 1 or 2 (mild/moderate) rash, which can be treated using emollients/moisturizers and topical corticosteroids. For Grade 3 rash, the prescribing information mandates immediate telaprevir discontinuation, with ribavirin interruption (with or without peginterferon) within 7 days of stopping telaprevir if there is no improvement, or sooner if it worsens. In case of suspicion or confirmed diagnosis of SCAR, all study medication must be discontinued.

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“…Topical steroids, emollients, and soothing baths may help to alleviate these symptoms, but studies have not shown a significant response [43]. Another typical adverse effect seen with interferons is alopecia, occurring in about one third of patients, with a higher prevalence in females [44]. To combat alopecia, the patient can cut his/her hair short prior to interferon initiation and avoid pulling, braiding, or vigorously combing the hair.…”

Section: Pegylated Interferonmentioning

confidence: 99%

Management of Hepatitis C Antiviral Therapy Adverse Effects

2010

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Hepatitis C is one of the leading causes of liver disease in the United States, affecting more than 4 million individuals. The current treatment regimen involves pegylated interferon in combination with ribavirin. Although antiviral treatment has been associated with a greater than 50% sustained viral response rate, the adverse effects have proven to be detrimental to quality of life and therapy adherence, and consequently lead to lower sustained viral response rates. This article identifies the most frequently described complications associated with pegylated interferon and ribavirin. The active management of these complications is discussed, including both preventive and empiric treatments.

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Localized Interferon Alfa-2b-Induced Alopecia

Cited by 30 publications

References 4 publications

A Prospective Study of Cutaneous Adverse Events Induced by Low-Dose Alpha-Interferon Treatment for Malignant Melanoma

A Prospective Study of Cutaneous Adverse Events Induced by Low-Dose Alpha-Interferon Treatment for Malignant Melanoma

Dermatological side effects of hepatitis C and its treatment: Patient management in the era of direct-acting antivirals

Management of Hepatitis C Antiviral Therapy Adverse Effects

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