Scarring Alopecia in Tumor Necrosis Factor-α Antagonists-Induced Scalp Psoriasis

Avital Baniel*, Alon Peled, Liat Samuelov, Valentina Zemser, Andrea Gat, Roni P. Dodiuk-Gad, Michael Ziv, Wassim Azzam, Eran Zittan, Hagit Matz, Eli Sprecher, Mor Pavlovsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: A broad spectrum of adverse reactions associated with the use of tumor necrosis factor alpha (TNFα) antagonists has been recognized over the past years. Induction of scalp psoriasis is a less known undesirable consequence of the use of these drugs and is not well characterized. Objective: To characterize TNFα inhibitors-induced psoriatic alopecia. Methods: We studied 6 patients with TNF-inhibitor induced psoriatic alopecia and reviewed 28 patients with this condition reported in the literature to date. Results: In addition to severe scalp psoriasis, we report hair follicle pathologies ranging from alopecia areata to scarring alopecia. Prognosis was good, but discontinuation of TNFα inhibitors was required in more than half of the cases in order to achieve a favourable outcome. Conclusion: TNFα inhibitors-associated psoriatic alopecia is rarely reported but requires a high index of suspicion and prompt diagnosis, as timely intervention may prevent irreversible damage.

Original languageEnglish
Pages (from-to)90-95
Number of pages6
JournalJournal of Psoriasis and Psoriatic Arthritis
Issue number3
StatePublished - Jul 2023


  • TNFα inhibitor
  • alopecia
  • psoriasis
  • scalp
  • scarring


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