[A report of successful management with simvastatin plus ezetimibe in alopecia areata]

Medwave. 2020 Nov 2;20(9):e8053. doi: 10.5867/medwave.2020.10.8053.
[Article in Spanish]

Abstract

Alopecia areata is a common type of non-scarring alo¬pecia. Although the exact pathogenesis remains elusive, alopecia areata is thought to have a multifactorial etiology described as an interplay of genetic predisposition and environmental exposures. In patients with genetic susceptibility, stress, infection, and microtrauma have been documented to decrease immunosuppressive cytokines that generally maintain the hair follicle's immune privilege. There is currently no curative therapy for alopecia areata, although some treatments can induce hair growth in a percentage of patients. It has been postulated that simvastatin reestablishes the immune privilege, and ezetimibe would provide an immunomodulatory and anti-inflammatory effect. We report a case of a 23 years-old woman with alopecia areata successfully treated with simvastatin/ezetimibe.

La alopecia areata es un tipo común de alopecia no cicatricial. Aunque la patogénesis exacta permanece sin dilucidar, se piensa que la alopecia areata tiene una etiología multifactorial en donde se interrelacionan predisposición genética y factores ambientales. En pacientes susceptibles, se han documentado que el estrés, infecciones y microtraumas disminuyen las citoquinas inmunosupresoras que normalmente mantienen el privilegio inmune del folículo piloso. Actualmente no hay terapia curativa para la alopecia areata, aunque ciertos tratamientos pueden inducir el crecimiento del cabello en un porcentaje de pacientes. Se postula que la simvastatina restablece el privilegio inmune y ezetimibe aportaría un efecto inmunomodulador y antiinflamatorio. Se presenta el caso de una mujer de 23 años con alopecia areata, exitosamente tratada con simvastatina y ezetimibe.

Keywords: Dermatology; Hair diseases; Alopecia areata.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alopecia Areata* / drug therapy
  • Alopecia Areata* / genetics
  • Ezetimibe* / therapeutic use
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Immunosuppressive Agents* / therapeutic use
  • Simvastatin* / therapeutic use
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Simvastatin
  • Ezetimibe