Alopecia areata in 2 patients treated with dupilumab: New onset and worsening

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that can be comorbid with the autoimmune disease alopecia areata (AA).1, 2 Dupilumab is a novel treatment for moderate-to-severe AD that may have implications in AA therapy given its role in inhibiting the helper T cell 2 response at the level of interleukin-4 receptor α subunit.3 This mechanism might target AA of the scalp where there can be upregulation of helper T cell 2 via interleukin-13 among other cytokines.3, 4 Here we present 2 cases of patients with hair loss while on dupilumab for AD—1 with new onset and subsequent improvement of alopecia universalis (AU), and one with worsening of previously diagnosed alopecia totalis (AT) while on treatment.