Recurrence of alopecia areata in a patient receiving etanercept injections

Background: Alopecia areata is a common condition of patchy hair loss that has been postulated to have an autoimmune pathogenesis involving inflammatory cytokines, including tumor necrosis factor (TNF) alpha. Etanercept is a novel medication that blocks TNF-alpha-mediated processes. We report a case involving the recurrence of alopecia areata in a patient receiving etanercept. Observations: We describe a 49-year-old man with a history of rheumatoid arthritis and alopecia areata who developed a recurrence of his alopecia areata while being treated with etanercept for more than 2 years. Conclusions: The anti-TNF-alpha effect of etanercept therapy may not be sufficient to prevent the recurrence of alopecia. areata. The possible role of TNF-alpha in the pathogenesis of alopecia areata may be called into question if our observation is repeated.