Reactivation of Alopecia Areata after Dupilumab Therapy for Atopic Dermatitis

Abstract

We present a case report of a 42-year-old woman with severe atopic dermatitis (AD) and history of alopecia areata (AA), which had been in remission for more than 5 years. She was treated with dupilumab for AD, and 4 months after initiating treatment, she developed a rapidly progressive reactivation of AA in an androgenic alopecia pattern. Alopecia resolved after a single intramuscular triamcinolone injection while the patient remained on dupilumab. This is the seventh report to date of dupilumab-associated alopecia but is the first case documenting reactivation of previous AA. Alopecia occurring after dupilumab initiation raises suspicion for a possible unrecognized adverse effect of dupilumab in AD patients.