Dermatologists from Massachusetts General Hospital were stunned when their 13-year-old patient – a girl who had suffered from severe eczema and persistent alopecia since infancy – began to regrow hair on her scalp after starting a regimen of a new immune-system-modifying drug.
Writing in the journal JAMA Dermatology, the team explains that the teen came into their care in the hopes of finding an effective treatment for her eczema, also referred to as atopic dermatitis, following years of trying various drugs and drug combinations with no improvement. The itchy red lesions characteristic of the condition covered about 70 percent of her body.
Two years of temporary successes and setbacks later, the physicians decided that she should try a brand-new drug called dupilumab. Approved in the Spring of 2017 for treatment of moderate to severe eczema, dupilumab is sold under the brand name Dupixent. It works by blocking the activation of a receptor on white blood cells involved in triggering an inflammatory allergic response. Over-activation of this receptor and several closely related receptors, through genetic variations and poorly understood environmental factors, is associated with asthma, hay fever, and food allergies, in addition to eczema.
After three injections of dupilumab over a period of six weeks, the patient’s eczema had improved significantly. And while that was exciting in itself, she was even more thrilled to notice that numerous vellus hairs – the short, fine, light-colored hairs that typically cover large areas of the body – were sprouting across her scalp. Due to her alopecia areata, the teen’s scalp had previously been completely bald (a state called alopecia totalis).
Nine months after beginning dupilumab treatment, she had grown pigmented hairs resembling normal head hairs on approximately 60 percent of her scalp.
“We were quite surprised since this patient hadn’t grown scalp hair since the age of two, and other treatments that can help with hair loss did not in her case,” senior author Dr Maryanne Makredes Senna said in a statement. “As far as we know, this is the first report of hair regrowth with dupilumab in a patient with any degree of alopecia areata.”