Characterization of Paradoxical Psoriasiform Alopecic Reactions Induced by Anti-TNFα in Patients with Chronic Inflammatory Bowel Disease

This study investigates paradoxical psoriasiform alopecic reactions in patients with inflammatory bowel disease undergoing anti-TNFα therapy, involving 24 patients from three Parisian hospitals. The cohort, primarily female with a median age of 30, mostly had Crohn's disease and experienced mild to moderate alopecia after a median of 10 months on adalimumab or infliximab. Histopathological analysis showed a consistent psoriasiform pattern without scarring, and management typically began with topical corticosteroids, escalating to discontinuation of anti-TNFα therapy in 58% of cases, often switching to ustekinumab. All patients showed clinical improvement and complete hair regrowth within 2 months, highlighting the non-scarring nature of the condition and the importance of early diagnosis and coordinated care.