case_images: PMC10588803_01
case_images: (A) Hair loss observed after starting therapy with secukinumab. (B) Alopecia areata was evident after completing the induction period (5 weeks) of secukinumab. Gradual improvement of Alopecia areata after 3 months (C) and 8 months (D) of secukinumab discontinuation and treatment with tofacitinib.
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case_images: However, after one week, she began to experience sudden hair loss (Figure 1A), which initially was not severe enough to warrant discontinuation of secukinumab. By the completion of the induction period, at week 5, the hair loss worsened and the patient developed significant AA (Figure 1B), characterized by a scaly rash on the scalp and distinct borders of hair loss. After three months of treatment, gradual improvement in AA was observed (Figure 1C). AA lesions was evident (Figure 1D). Additionally, the patient's palm pustules (Figure 2Ai) and nail damage (Figure 2Aii) associated with PPP showed improvement following completion of the induction period of secukinumab (Figure 2Bi and Bii).
case_images: Presentation of severe erythematous keratotic lesions and pustules on the palms (Ai) and yellowing of nails (Aii), suggestive of palmoplantar pustulosis. Improvement of palms (Bi) and nails (Bii) after treatment with secukinumab. The palmoplantar pustules were alleviated after 3 months (Ci, Cii) and 8 months (Di, Dii) of discontinuing secukinumab and receiving treatment with tofacitinib.
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case_images: AA lesions was evident (Figure 1D). Additionally, the patient's palm pustules (Figure 2Ai) and nail damage (Figure 2Aii) associated with PPP showed improvement following completion of the induction period of secukinumab (Figure 2Bi and Bii). Notably, significant alleviation of PPP symptoms was observed based on clinical photographs after 3 months (Figure 2Ci and Cii) and 8 months (Figure 2Di and Dii) of discontinuing secukinumab and initiating treatment with tofacitinib.