%0 Journal Article
%T Alopecia Diffusa while Using Interleukin-17 Inhibitors against Psoriasis Vulgaris
%A Keiichi Yamanaka
%A Koji Habe
%A Makiko Yajima
%A Makoto Kondo
%A Tomoko Akeda
%J Archive of "Case Reports in Dermatology".
%D 2019
%R 10.1159/000499030
%X We report two cases of alopecia diffusa during the treatment of psoriasis vulgaris with interleukin (IL)-17 inhibitors. Psoriasis is one of the most common immune-mediated chronic skin diseases, strongly associated with IL-17A. Clinically, the monoclonal antibodies to IL-17A or its receptor, IL-17R, show a dramatic effect against psoriasis. Alopecia is also an IL-17-mediated autoimmune disease, and IL-17 inhibitors have been expected to be the gold standard for the treatment of alopecia; therefore, the complication of alopecia while using IL-17 may be regarded as an unexpected ˇ°paradoxical reaction.ˇ± T helper (Th)17 cells are not cytotoxic enough by themselves to undermine the hair follicle under normal circumstances, they need the coexistence of CD8+ cytotoxic Th1 cells. Th17 cells may be the initiator of the damage of the hair follicle, but CD8 T cells or more powerful Th1 cells are required as followers. The Th17/Th1 axis might convert into a Th1-dominant immune status using IL-17 inhibitors, and the destruction of the hair follicle might result in alopecia. An accumulation of cases is to be expected
%K Alopecia diffusa
%K Interleukin-17
%K Psoriasis vulgaris
%K Th17 cells
%K Th1 cells
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489098/