Effective use of ustekinumab in a patient with concomitant psoriasis, vitiligo, and alopecia areata

Alopecia areata: A multifactorial autoimmune condition

“…Ustekinumab is an IgG antibody against the p40 subunit of IL-12 and IL-23 which inhibits their activity and subsequent induction of IFN-γ, IL-17A, TNF-α, IL-2, and IL-10 secretion from the immune cells [143][144][145]. The IL-12 and IL-23 cytokines are characteristic of Th1 and Th17 responses which are linked to alopecia areata and other autoimmune skin conditions such as psoriasis and vitiligo, so inhibiting them can be therapeutic in autoimmunity [144][145][146][147]. However, despite the theory, inhibition of these cytokines has shown controversial results.…”

“…However, despite the theory, inhibition of these cytokines has shown controversial results. One study observed that alopecia areata coexisting with psoriasis, was improved after ustekinumab treatment [147]. Other studies however, have shown that while such treatment is effective for psoriasis, it has an negative effect for inducing alopecia areata even in patients without family history of disease [144,145].…”

Effective use of oral tofacitinib and phototherapy in a patient with concomitant alopecia areata, vitiligo, and plaque and inverse psoriasis

“…One example is a patient reported by Elkady et al, who had concomitant AA, psoriasis, and vitiligo. The use of ustekinumab in this patient was associated with a complete remission in psoriasis in 16 weeks and partial remission in AA and vitiligo …”

Cutaneous Manifestations in Biological-Treated Inflammatory Bowel Disease Patients: A Narrative Review

“…The results were, however, not significant in the subgroup of IBD patients [HR = 2.47 (95% CI: 0.69–8.87) and HR = 0.58 (95% CI: 0.09–3.85) for CD and UC, respectively] [ 74 ]. Both cases with new-onset vitiligo and alopecia areata on ustekinumab as successful treatments in patients with these disorders have been reported [ 75 , 76 , 77 , 78 , 79 ].…”