Does Immunosuppression Help Control Alopecia Areata? A Study in Transplant Recipients

Alopecia areata (AA) is a polygenic autoimmune disease. The immunosuppressant drugs taken by patients who undergo solid organ transplantation might therefore be useful in its control. The literature, however, contains conflicting information in this regard. This contribution describes seven patients with AA, all of whom had undergone solid organ transplantation and were receiving treatment with immunosuppressant drugs. Patterns were sought that might suggest whether the administration of these drugs was affecting the appearance, progress, or resolution of AA. Only seven out of 469 patients (incidence 1.5%) who had undergone solid organ transplantation presented at our dermatology clinic with AA. All seven had undergone kidney transplantation. Five patients also had another autoimmune disease. Two of the seven patients developed AA before undergoing transplantation. No relationship was seen between the appearance or progress of AA and treatment with immunosuppressant drugs. The present results provide further evidence that AA may appear alongside other autoimmune disease. No clear picture emerges regarding whether immunosuppressants prevent the appearance of AA, help in its resolution, or encourage its onset. (SKINmed. 2019;17:18-22).