Alopecia Universalis Associated with Hyperthyroidism Treated with Azathioprine and Hydroxychloroquine: A Case Report

Paudel, Vikash; Chudal, Deepa; Pradhan, Manish; Thakur, Rupa; Pandey, Buddhi Raj

doi:10.31729/jnma.5830

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Ultimately hydroxychloroquine and azathioprine were added as adjunct therapy with discontinuation of oral steroids after one week. One month later, the patient developed improvement in hair growth in the scalp region (86). Similar cases where hydroxychloroquine and azathioprine as treatment for AA have also been described elsewhere in the literature (87,88).…”

Section: Hair Alopecia Areatasupporting

confidence: 66%

Dermatologic manifestations of thyroid disease: a literature review

2023

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IntroductionThyroid hormone is considered one of the key regulatory hormones for skin homeostasis. Multiple organs are affected by the release of peripheral thyroid hormones (T4 and T3) further regulating various functions at a cellular level. Specifically, skin is considered an important target organ in which the thyroid hormone has a significant impact. Multiple skin diseases are associated with thyroid hormone dysregulation. However, other striking dermatologic manifestations are seen in nails and hair as well. Hypothyroidism, hyperthyroidism, and thyroid cancer can have an array of cutaneous manifestations, and we present the recent updates in this field.MethodsA PubMed search was performed for updates in any new skin disease findings and treatments between 2010 and 2022. Research published in the past decade and previously known foundational skin findings associated with thyroid disease were presented in this review.ConclusionCutaneous manifestations of thyroid disease is one of the first notable signs of thyroid hormone dysregulation. This article reviews the recent updates on the thyroid and skin interplay, and it further discusses overt visible findings and various available treatment modalities.

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Section: Hair Alopecia Areatasupporting

confidence: 66%

Dermatologic manifestations of thyroid disease: a literature review

2023

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“…3,4 Hydroxychloroquine is an anti-inflammatory drug that has been shown to have variable success in treatment of AA, AT, and AU. [5][6][7][8][9][10] We herein report a 61-year-old female who presented with a 20-year history of AU, and biopsy confirmed widespread granuloma annulare. Hydroxychloroquine was initiated to treat her granuloma annulare, and she was subsequently noted to have significant hair regrowth on her scalp, eyebrows, eyelashes, and arms.…”

Section: Introductionmentioning

confidence: 80%

“… 3 , 4 Hydroxychloroquine is an anti-inflammatory drug that has been shown to have variable success in treatment of AA, AT, and AU. 5 – 10 …”

Section: Introductionmentioning

confidence: 99%

Hydroxychloroquine for granuloma annulare: A case report on secondary hair growth in alopecia universalis

Osman

Traboulsi

2023

SAGE Open Medical Case Reports

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Alopecia areata is an autoimmune disease resulting in non-scarring hair loss. Alopecia areata can progress to become alopecia totalis (loss of hair from the entire scalp) or alopecia universalis (loss of hair form the entire body), with the progression estimated to range from 7% to 30%. There are no universally proven therapies that both induce and sustain remission, and furthermore, the course of alopecia areata tends to be unpredictable, with ~80% of patients achieving spontaneous remission within 1 year. We herein present the case of a 61-year-old female who presented with a 20-year history of alopecia universalis, and biopsy confirmed widespread granuloma annulare. Hydroxychloroquine was initiated to treat her granuloma annulare, with subsequent significant hair regrowth on her scalp, eyebrows, eyelashes, and arms. A review of the literature is presented showing that hydroxychloroquine has variable success in treatment of alopecia areata, alopecia totalis, and alopecia universalis.

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“…Of note, the two most common side effects experienced were gastrointestinal intolerance and headache [41]. One patient with alo-pecia universalis (AU) showed signs of hair regrowth after roughly 1 month with a combination of azathioprine and HCQ [42]. The most recent case report published in 2023 found another AU patient exhibiting positive clinical outcomes on HCQ [4].…”

Section: Alopecia Areatamentioning

confidence: 99%

Use of Hydroxychloroquine in Hair Disorders

Ravipati,

Randolph,

Al-Salhi

et al. 2023

Skin Appendage Disord

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Hydroxychloroquine (HCQ) is an antimalarial that is utilized to treat a range of dermatologic and autoimmune disorders. With its ability to alter immunologic mechanisms, it has been used to slow or halt the progression of hair loss in conditions secondary to autoimmune dysfunction. Lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), and alopecia areata (AA) are hair disorders with underlying autoimmune components and no standardized treatment guidelines. We summarized the available literature on the use of HCQ to treat LPP, FFA, and AA. For all three conditions, HCQ showed variable efficacy from halted hair loss to no improvement. While patients did show success with HCQ treatment, there were no clear treatment patterns. Regimens ranged from HCQ monotherapy to combination treatments with other agents like steroids. Overall, HCQ should certainly be considered by clinicians as a treatment option for patient suffering from these hair disorders. While there is no standardized treatment, incorporation of HCQ should take into consideration individual patient characteristics, clinical judgment, and risks of side effects.

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Alopecia Universalis Associated with Hyperthyroidism Treated with Azathioprine and Hydroxychloroquine: A Case Report

Cited by 3 publications

References 8 publications

Dermatologic manifestations of thyroid disease: a literature review

Dermatologic manifestations of thyroid disease: a literature review

Hydroxychloroquine for granuloma annulare: A case report on secondary hair growth in alopecia universalis

Use of Hydroxychloroquine in Hair Disorders

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