Reactions 1680, p220 - 2 Dec 2017 Alopecia areata: case report An 11-year-old girl developed alopecia areata (AA) during treatment with methotrexate. The girl, who had a history of crohn’s disease (CD), was initially started on induction therapy with prednisolone. A slow tapering of prednisolone was done and she started receiving maintenance therapy with azathioprine. After a few doses of azathioprine, she developed an allergic reaction characterised by fever and skin eruption, requiring its discontinuation. The prednisolone slowly tapered and discontinued. She continued to be asymptomatic without reoccurrence of fever or any other symptoms. Seven months later, her underlying CD was found to be active. The prednisolone was restarted followed by a weekly SC injections of methotrexate 15 mg/m . The prednisolone was again discontinuation. Fifteen months after commencing the methotrexate therapy, she developed localised areas of alopecia. She was diagnosed with AA based on a characteristic ophiasis means snake like pattern extending from her occipital to parietal and frontotemporal scalp areas. There was also appearance of localised spots of hair loss in her eye lashes. The girl was treated with intralesional injections of triamcinolone which resulted in 90% hair regrowth. Six months later, the alopecia recurred and she had even more hair loss. A serial injections of triamcinolone every four weeks for three months lead to 75% hair regrowth. Author comment: "Our patient developed AA while on maintenance treatment with [methotrexate]. While it has been linked to alopecia in [inflammatory bowel disease] patients in some reports, no study has specifically examined [methotrexate] as a cause of AA." Sankararaman S, et al. Alopecia Areata in an Adolescent with Inflammatory Bowel Disease. Clinical Pediatrics 56: 1350-1352, No. 14, 2017. Available from: URL: http://doi.org/10.1177/0009922816678185 - USA 803286061 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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