Successful treatment of refractory alopecia universalis with infliximab: First case report in Sri Lanka

Alopecia areata is a common organ specific autoimmune disorder affecting the hair follicle causing non scarring alopecia. Exact pathogenesis of alopecia areata is not known but both cell mediated and humoral immunity is implicated to have a role. TNF alpha is an important cytokine with a dual role in alopecia areata, both promoting hair loss as well as protecting against hair loss. There are case reports of alopecia areata developing following treatment with infliximab for other indications. Isolated cases of refractory alopecia improving with infliximab therapy are also reported.

We present a 41 year-old woman with alopecia areata that rapidly progressed to alopecia universalis refractory to standard treatment which was successfully treated with TNF alpha inhibitor infliximab.