JAMA Dermatol. 2014 Dec;150(12):1341-4. doi: 10.1001/jamadermatol.2014.1544.
IMPORTANCE Alopecia universalis is an uncommon form of alopecia areata (AA) involving hair loss over the entire scalp and body and is often difficult to treat. Tumor necrosis factor (TNF)inhibitors have been largely unsuccessful in treating AA and have been reported to induce or worsen AA in patients.We report herein a case of alopecia universalis successfully treated with adalimumab and discuss the possible mechanism.OBSERVATIONS A woman in her 30s with alopecia universalis, refractory to multiple treatment modalities, was successfully treated with adalimumab.CONCLUSIONS AND RELEVANCE Tumor necrosis factor has multiple important roles in the pathogenesis of AA, and its interplay with other cytokines, specifically interferons, may be responsible for the development of AA in patients treated with TNF inhibitors.Pharmacogenetics and the inherent physiologic levels of TNF may explain why TNF inhibitors cause AA in some individuals, while treating AA in others. These conclusions warrant further investigation on this subject.
普秃是一种罕见的斑秃（AA）形式，涉及整个头皮和全身的脱发，通常难以治疗。肿瘤坏死因子（TNF）抑制剂在治疗 AA 方面基本上没有成功，并且据报道会在患者中诱导或加重 AA。我们在此报告一例普秃成功用阿达木单抗治疗的病例，并讨论可能的机制。
一位 30 多岁的女性患有普秃，对多种治疗方式均有抗药性，用阿达木单抗成功治疗。
肿瘤坏死因子在 AA 的发病机制中具有多种重要作用，其与其他细胞因子（特别是干扰素）的相互作用可能是接受 TNF 抑制剂治疗的患者发生 AA 的原因。药物遗传学和 TNF 的固有生理水平可能解释了为什么 TNF 抑制剂在某些个体中引起 AA，而在另一些个体中治疗 AA。这些结论需要进一步对此主题进行调查。
