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William Posten, MD; James Swan, MD

Arch Dermatol. 2005;141:759-760.

Background  Alopecia areata is a common condition of patchy hair loss that has been postulated to have an autoimmune pathogenesis involving inflammatory cytokines, including tumor necrosis factor (TNF) . Etanercept is a novel medication that blocks TNF-–mediated processes. We report a case involving the recurrence of alopecia areata in a patient receiving etanercept.

Observations  We describe a 49-year-old man with a history of rheumatoid arthritis and alopecia areata who developed a recurrence of his alopecia areata while being treated with etanercept for more than 2 years.

Conclusions  The anti–TNF- effect of etanercept therapy may not be sufficient to prevent the recurrence of alopecia areata. The possible role of TNF- in the pathogenesis of alopecia areata may be called into question if our observation is repeated.

Author Affiliations: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Ill.

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