Appearance of Alopecia Areata During Treatment With Tildrakizumab for Severe Palmoplantar Psoriasis

A 50-year-old woman with severe palmoplantar psoriasis developed alopecia areata (AA) 2 months after starting tildrakizumab treatment. With no history of autoimmune disorders, AA was confirmed through clinical evaluation. Discontinuing tildrakizumab and starting corticosteroid treatment led to complete hair regrowth in 6 months. Psoriasis recurred but was managed with bimekizumab, achieving remission without adverse events. This case suggests a potential causal link between tildrakizumab and AA, emphasizing the need for awareness of autoimmune reactions during IL-23 inhibition therapy.