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Biological therapies for autoimmune diseases have been a focus of research and attention recently. Etanercept, in particular, is becoming more commonly used in dermatologic practice as an inhibitor of skin diseases mediated by tumor necrosis factor alfa (TNF-α). In dermatologic practice, psoriasis is the major disease treated with etanercept, although one might expect other TNF-α–mediated skin diseases to respond similarly well. In this case report, Posten and Swan describe a patient with rheumatoid arthritis whose concurrent alopecia areata unexpectedly worsened during etanercept therapy. This case highlights the complex nature of the cytokine interactions that are likely involved in alopecia areata and the possibility that TNF-α may not be essential to the pathologic mechanisms of this disease.
This Month in Archives of Dermatology. Arch Dermatol. 2005;141(6):671. doi:10.1001/archderm.141.6.671
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