Caractérisation des Réactions Paradoxales Psoriasiformes Alopéciantes Induites par les Anti-TNFα chez des Patients Atteints de Maladies Inflammatoires Chroniques de l’Intestin

This study investigated paradoxical psoriasiform alopecic reactions in 24 patients with inflammatory bowel disease treated with anti-TNFα therapies, primarily adalimumab and infliximab. The cohort, mostly female with a median age of 30, showed mild to moderate alopecia with erythematosquamous plaques, often accompanied by bacterial superinfections. Histopathological analysis revealed a psoriasiform pattern with features overlapping eczematous dermatitis or alopecia areata, but without scarring. Management typically began with topical corticosteroids, escalating to discontinuation of anti-TNFα therapy and switching to ustekinumab in 58% of cases. All patients experienced complete hair regrowth within 2 months, highlighting the non-scarring nature of the condition. This study emphasizes the importance of early diagnosis and collaboration between gastroenterologists and dermatologists.