Ostojic, P. (8503557700)P. (8503557700)OstojicPavlov-Dolijanovic, S. (8452470400)S. (8452470400)Pavlov-Dolijanovic2025-06-122025-06-122018https://doi.org/10.1007/s00393-018-0464-zhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85046653183&doi=10.1007%2fs00393-018-0464-z&partnerID=40&md5=67aa2c733f9217f8df59e841cb49b6adhttps://remedy.med.bg.ac.rs/handle/123456789/6304Alopecia universalis is an advanced form of alopecia areata, characterized by complete loss of hair on all hair-bearing areas. It is currently believed to be an autoimmune disorder. The development of alopecia during treatment with tumor necrosis factor alpha (TNF-α) inhibitors is a rarely observed adverse event. This case describes a 56-year-old female patient with rheumatoid arthritis (RA), who developed alopecia universalis during treatment with adalimumab. There was no improvement in alopecia despite withdrawal of adalimumab. It is believed that interferon-α is the main cytokine involved in promoting inflammation in hair loss after blocking TNF-α by TNF inhibitors. Risk/benefit ratio of maintenance and discontinuation of the drug should be weighed up when alopecia appears during treatment with TNF inhibitors. © 2018, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.Adverse eventAlopecia areataAutoimmunityInterferon-αTNF-inhibitors