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Published on December 31, 2015 | http://doi.org/10.5867/medwave.2015.11.6350

Alopecia areata secondary to the use of leflunomide in patients with rheumatoid arthritis: a case report and literature review

Alopecia areata por uso de leflunomida en una paciente con artritis reumatoide: reporte de caso y revisión de literatura

María Ignacia Molina Molina , Carmen María Pinochet Paiva, José Ignacio Quezada Morales

Abstract

Rheumatoid arthritis is a chronic, highly disabling autoimmune disease that requires aggressive pharmacological treatment using immunomodulatory drugs grouped under the name of Disease-Modifying Anti-rheumatic Drugs (DMARDs). Leflunomide is one of the most frequently prescribed. This drug, through its mechanism of action is able to suppress key factors in the disease process. However, its use is not without side effects. While there are series that report that the most prevalent adverse effects are diarrhea, nausea, rash and alopecia, there are few reported cases of alopecia universalis secondary to the use of leflunomide. We present a case in the Regional Hospital of Talca and a review of the use of leflunomide

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Authors

María Ignacia Molina Molina

Facultad Medicina, Universidad Católica del Maule, Talca, Chile

mignaciamolina@gmail.com

Avenida San Miguel 3605, Talca, Región del Maule, Chile

Carmen María Pinochet Paiva

Hospital Regional de Talca, Región del Maule, Chile

José Ignacio Quezada Morales

Facultad Medicina, Universidad Católica del Maule, Talca, Chile

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History

Citation Molina Molina MI, Pinochet Paiva CM, Quezada Morales JI. Alopecia areata secondary to the use of leflunomide in patients with rheumatoid arthritis: a case report and literature review. Medwave 2015;15(11):e6350 doi: 10.5867/medwave.2015.11.6350

Submission date 09/11/2015

Acceptance date 22/12/2015

Publication date 31/12/2015

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Notes

Keywords

rheumatoid arthritis, alopecia areata, alopecia universalis, leflunomide

Origin and peer review

con revisión por un par revisor externo, a doble ciego

References

  1. Cardiel MH; Latin American Rheumatology Associations of the Pan-American League of Associations for Rheumatology (PANLAR); Grupo Latinoamericano de Estudio de Artritis Reumatoide (GLADAR). First Latin American position paper on the pharmacological treatment of rheumatoid arthritis. Rheumatology (Oxford). 2006 Jun;45 Suppl 2:ii7-ii22. | PubMed
  2. Smolen JS, Emery P. Efficacy and safety of leflunomide in active rheumatoid arthritis. Rheumatology (Oxford). 2000 Jun;39 Suppl 1:48-56. | PubMed
  3. Wiacek R, Kolossa K, Jankowski T, Jeka S, Karmowski A, Karmowski M, et al. The efficacy and safety of leflunomide in patients with active rheumatoid arthritis. Adv Clin Exp Med. 2012 May-Jun;21(3):337-42. | PubMed
  4. Smolen JS, Kalden JR, Scott DL, Rozman B, Kvien TK, Larsen A, et al. Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomised, multicentre trial. European Leflunomide Study Group. Lancet. 1999 Jan 23;353(9149):259-66. | PubMed
  5. Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010 Feb;62(2):177-88, quiz 189-90. | CrossRef | PubMed
  6. Safavi K. Prevalence of alopecia areata in the First National Health and Nutrition Examination Survey. Arch Dermatol. 1992 May;128(5):702. | PubMed
  7. Finner AM. Alopecia areata: Clinical presentation, diagnosis, and unusual cases. Dermatol Ther. 2011 May-Jun;24(3):348-54. | CrossRef | PubMed
  8. Schneider MR, Schmidt-Ullrich R, Paus R. The hair follicle as a dynamic miniorgan. Curr Biol. 2009 Feb 10;19(3):R132-42. | CrossRef | PubMed
  9. Gilhar A, Etzioni A, Paus R. Alopecia areata. N Engl J Med. 2012 Apr 19;366(16):1515-25. | CrossRef | PubMed
  10. Ito T, Ito N, Saatoff M, Hashizume H, Fukamizu H, Nickoloff BJ, et al. Maintenance of hair follicle immune privilege is linked to prevention of NK cell attack. J Invest Dermatol. 2008 May;128(5):1196-206. | PubMed
  11. Meyer KC, Klatte JE, Dinh HV, Harries MJ, Reithmayer K, Meyer W, et al. Evidence that the bulge region is a site of relative immune privilege in human hair follicles. Br J Dermatol. 2008 Nov;159(5):1077-85. | CrossRef | PubMed
  12. Kuchabal SD, Kuchabal DS. Alopecia Areata Associated with Localized Vitiligo. Case Rep Dermatol. 2010 Mar 27;2(1):27-31. | PubMed
  13. Ito T. Recent advances in the pathogenesis of autoimmune hair loss disease alopecia areata. Clin Dev Immunol. 2013;2013:348546. | CrossRef | PubMed
  14. Gottenberg JE, Venancie PY, Mariette X. Alopecia areata in a patient with rheumatoid arthritis treated with leflunomide. J Rheumatol. 2002 Aug;29(8):1806-7. | PubMed
  15. Navarro R, Daudén E, Gallo E, Santiago Sánchez-Mateos D, García-Diez A. Alopecia areata during treatment of psoriasis with adalimumab and leflunomide: a case and review of the literature. Skin Pharmacol Physiol. 2012;25(2):107-10. | CrossRef | PubMed
  16. Chaves Y, Duarte G, Ben-Said B, Tebib J, Berard F, Nicolas JF. Alopecia areata universalis during treatment of rheumatoid arthritis with anti-TNF-alpha antibody (adalimumab). Dermatology. 2008;217(4):380. | CrossRef | PubMed
  17. Lazzarini R, Capareli GC, Buense R, Lellis RF. Alopecia universalis during treatment with leflunomide and adalimumab - case report. An Bras Dermatol. 2014 Mar-Apr;89(2):320-2. | PubMed
  18. Costa L, Atteno M, Caso F, Scarpato L, Del Puente A, Scarpa R. Alopecia areata in a patient with psoriatic arthritis and Crohn's disease receiving etanercept. Int J Rheum Dis. 2014 Feb;17(2):219-20. | CrossRef | PubMed