A new case study published in the journal JAMA Dermatology reveals a young patient suffering from severe eczema along with a longstanding case of alopecia totalis – a condition resulting in the complete loss of hair on the scalp and face – has displayed major hair regrowth after being treated with a newly approved eczema drug.
The fascinating report describes how the 13-year-old female patient was treated with a drug called dupilumab for her treatment-resistant eczema. Since the age of just seven months, the patient had suffered from severe atopic dermatitis, only experiencing limited improvements from other generally administered treatments.
Dupilumab, a monoclonal antibody initially developed as a treatment for severe eczema, was approved for clinical use by the FDA is early 2017. After six weeks of treatment with the drug, the patient reported fine light hairs beginning to grow on her scalp, and after seven months of treatment this developed into a significant amount of pigmented hair.
"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," says Maryanne Makredes Senna, senior author on the new report. "As far as we know, this is the first report of hair regrowth with dupilumab in a patient with any degree of alopecia areata."
The causal connection between the treatment and the hair growth was solidified when, due to problems with the patient's insurance coverage, the dupilumab was temporarily halted for two months. When the treatment paused, the patient subsequently shed the regrown hair, but once treatment could be resumed, the hair growth returned.
The researchers hypothesize that the hair growth may have been stimulated by the treatment's targeting of an immune system pathway fundamental to both severe eczema and autoimmune-induced hair loss. However, at this stage it is unclear exactly whether this treatment could help other alopecia patients.
"Right now, it's hard to know whether dupilumab could induce hair growth in other alopecia patients, but I suspect it may be helpful in patients with extensive active eczema and active alopecia areata," says Senna. "We've submitted a proposal for a clinical trial using dupilumab in this patient population and hope to be able to investigate it further in the near future."
Interestingly, this isn't the first accidental hair loss treatment doctors have stumbled across. Several other studies have reported hair growth as an unexpected side effect of other drugs or treatments. Earlier this year researchers revealed that experiments with a 50-year-old immunosuppressive drug resulted in surprising enhancement of hair growth, and back in 2011 a team working on novel brain-gut interactions inadvertently discovered a chemical compound that induces hair growth.
Despite a great deal of work in the field, scientists still haven't found an effective way to stimulate hair regrowth. This new case study may at this stage just describe an outlier patient with a unique response, but it's these kinds of wonderful accidents that spawn so many scientific discoveries.
The study was published in the journal JAMA Dermatology.
Source: Massachusetts General Hospital
Medicine has come a long way but in so many ways it's still in its infancy.