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Imiquimod in the treatment of alopecia universalis
Philip R Letada1, Joshua D Sparling, Christopher Norwood
1National Naval Medical Center, Bethesda, Maryland, USA.
Imiquimod is used topically in the treatment of numerous dermatologic conditions. Imiquimod modifies the immune response through cytokine induction of the T-cell helper subset, correlating with the expression of interferon alpha, tumor necrosis factor alpha, interferon gamma, and interleukins (ILs) 1 and 12. Reciprocal inhibition of TH2 immune response occurs via up-regulation of interferon gamma and down-regulation of TH2-associated cytokines, including IL-4, IL-5, IL-6, IL-10, and IL-13. Alopecia universalis is a severe form of alopecia thought to arise from T-cell mediated autoimmune disease of the hair follicle. There have been no case reports noting a beneficial effect of topical imiquimod in the treatment of alopecia universalis. We present a case of a 15-year-old adolescent girl with alopecia universalis since age 8 who experienced transient hair growth after topical application of imiquimod.
Imiquimod is used topically in the treatment of numerous dermatologic conditions. Imiquimod modifies the immune response through cytokine induction of the T-cell helper subset, correlating with the expression of interferon alpha, tumor necrosis factor alpha, interferon gamma, and interleukins (ILs) 1 and 12. Reciprocal inhibition of TH2 immune response occurs via up-regulation of interferon gamma and down-regulation of TH2-associated cytokines, including IL-4, IL-5, IL-6, IL-10, and IL-13. Alopecia universalis is a severe form of alopecia thought to arise from T-cell mediated autoimmune disease of the hair follicle. There have been no case reports noting a beneficial effect of topical imiquimod in the treatment of alopecia universalis. We present a case of a 15-year-old adolescent girl with alopecia universalis since age 8 who experienced transient hair growth after topical application of imiquimod.
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