Pityriasis amiantacea and folliculitis decalvans

Abstract

We report on a 21-year-old woman with a 3-year history of crusts and erosions on her scalp that had appeared after starting treatment with adalimumab due to Crohn's disease. By clinicopathological correlation pityriasis amiantacea with underlying folliculitis decalvans was diagnosed. Topical and systemic antibiotic treatment showed rapid response. The occurrence of pityriasis amiantacea in folliculitis decalvans associated with tumor necrosis factor (TNF)-α inhibitor therapy is remarkable and highlights the ambivalent role of TNF-α in diseases with immunological dysfunctions in combination with infections.

The Association between Alopecia and Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

“…There are reports of 134 patients who developed alopecia as a side effect of IBD therapy (Table 4). Of those, 78 (58.2%) were on anti-TNF-α therapy (infliximab, adalimumab, certolizumab); 50 (37.3%) on thiopurine (azathioprine; 6-thioguanine), 4 (2.98%) on methotrexate, 1 (0.74%) on mesalamine, and 1 (0.74%) on sulfasalazine [3, 10, 13-16, 18-20, 25, 26, 29, 36, 37, 39-42, 44, 45, 50, 57, 60, 62, 64, 69-78, 80, 84-86, 88].…”

“…Five patients were diagnosed with secondary scarring alopecia, including psoriasiform dermatitis and pityriasis amiantacea with FD ( n = 2), psoriatic alopecia with scarring features ( n = 2), and LPP ( n = 1) [10, 19, 29, 64]. Topical therapy led to partial-complete resolution of scarring alopecia; 1 patient experienced resolution of alopecia with residual scarring following ustekinumab therapy[10].…”