Psoriatic Alopecia/Alopecia Areata-Like Reactions Secondary to Anti-Tumour Necrosis Factor-Alpha Therapy

Anti-tumour necrosis factor (TNF) agents have improved the quality of life for many individuals with autoimmune conditions such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease. A rarer emerging adverse cutaneous reaction of the drug is the development of psoriasiform alopecia areata, which may present acutely or be delayed for many months to years. This case series will highlight histopathological features pertinent for diagnosis, help distinguish secondary reactions from primary psoriatic alopecia, and help guide management, resulting in less inappropriate discontinuation of therapy.