Original Article

Imiquimod in the Treatment of Alopecia Universalis

Letada PR, Sparling JD, Norwood C

Cutis. 2007;79:138-140.

Imiquimod is used topically in the treatment of numerous dermatologic conditions. Imiquimod modifies the immune response through cytokine induction of the T-cell helper subset, correlating with the expression of interferon α, tumor necrosis factor α, interferon γ, and interleukins (ILs) 1 and 12. Reciprocal inhibition of T_H2 immune response occurs via up-regulation of interferon γ and down-regulation of T_H2-associated cytokines, including IL-4, IL-5, IL-6, IL-10, and IL-13. Alopecia universalis is a severe form of alopecia thought to arise from T-cell mediated autoimmune disease of the hair follicle. There have been no case reports noting a beneficial effect of topical imiquimod in the treatment of alopecia universalis. We present a case of a 15-year-old adolescent girl with alopecia universalis since age 8 who experienced transient hair growth after topical application of imiquimod.

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