Resolution of alopecia areata after switching from vedolizumab to ustekinumab in a patient with Crohn’s disease: a case report
Abstract
BackgroundCrohn’s disease (CD) is a chronic inflammatory bowel disease that can be associated with extraintestinal manifestations. Alopecia areata (AA) is an autoimmune non-scarring hair loss disorder. Their coexistence is uncommon, and managing both conditions simultaneously is challenging when intestinal and cutaneous responses diverge. Ustekinumab, a monoclonal antibody targeting the shared IL-12/IL-23 pathway, may offer a dual therapeutic benefit, but evidence in comorbid cases is limited.Case introductionWe report an 18-year-old man with a 2-year history of recurrent paroxysmal abdominal pain and mucoid hematochezia, as well as patchy non-scarring scalp alopecia. Computed tomography enterography and colonoscopy showed segmental bowel wall thickening and diffuse pinpoint erosions; histopathological examination demonstrated non-caseating granulomas, supporting a diagnosis of CD. Vedolizumab induction therapy with methylprednisolone bridging resulted in disease remission. The patient’s hair loss persisted, and he was diagnosed with AA. After his AA failed to respond to topical corticosteroids, his treatment was switched from vedolizumab to ustekinumab (390 mg intravenously at week 0, followed by 90 mg subcutaneously every 8 weeks). By week 24, marked scalp hair regrowth was evident, and by week 48, complete resolution of AA was achieved, while his CD remained in remission.ConclusionThis case suggests that ustekinumab may be a feasible therapeutic option for patients with coexisting CD and refractory AA, particularly when a shared IL-12/IL-23-mediated inflammatory pathway is suspected. Further prospective studies are required to confirm its efficacy and generalizability in this setting.
Related
- Comparative Safety of Ustekinumab and Vedolizumab in Older Patients with Inflammatory Bowel Disease: A Bicentric Cohort Study
- Inflammatory Bowel Disease Patients’ Acceptance for Switching from Intravenous Infliximab or Vedolizumab to Subcutaneous Formulation: The Nancy Experience
- Ustekinumab for Extraintestinal Manifestations in Patients With Inflammatory Bowel Disease: Lessons From the TENOR Real-World Study.
- Vedolizumab use for severe chronic enterocolitis in a child with Hoyeraal–Hreidarsson syndrome: A case report
- A Case of Refractory Pouchitis with Postoperative Anal Stenosis after Ileal Pouch-anal Anastomosis Treated with Vedolizumab, a Radial Incision and Cutting
BibTeX
@article{ma2026resolution,
title = {{Resolution of alopecia areata after switching from vedolizumab to ustekinumab in a patient with Crohn’s disease: a case report}},
author = {Yanyan Ma and Ankai Deng and Shuting Wen and Qimou Pan and Xiaofeng Lin and Sayun Shao and Tianwen Liu and Xiying Zhao},
journal = {Frontiers in Immunology},
year = {2026},
month = nov,
doi = {10.3389/fimmu.2026.1898290},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1898290},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Resolution of alopecia areata after switching from vedolizumab to ustekinumab in a patient with Crohn’s disease: a case report
AU - Yanyan Ma
AU - Ankai Deng
AU - Shuting Wen
AU - Qimou Pan
AU - Xiaofeng Lin
AU - Sayun Shao
AU - Tianwen Liu
AU - Xiying Zhao
PY - 2026
DA - 2026/11/06
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1898290
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1898290
AB - BackgroundCrohn’s disease (CD) is a chronic inflammatory bowel disease that can be associated with extraintestinal manifestations. Alopecia areata (AA) is an autoimmune non-scarring hair loss disorder. Their coexistence is uncommon, and managing both conditions simultaneously is challenging when intestinal and cutaneous responses diverge. Ustekinumab, a monoclonal antibody targeting the shared IL-12/IL-23 pathway, may offer a dual therapeutic benefit, but evidence in comorbid cases is limited.Case introductionWe report an 18-year-old man with a 2-year history of recurrent paroxysmal abdominal pain and mucoid hematochezia, as well as patchy non-scarring scalp alopecia. Computed tomography enterography and colonoscopy showed segmental bowel wall thickening and diffuse pinpoint erosions; histopathological examination demonstrated non-caseating granulomas, supporting a diagnosis of CD. Vedolizumab induction therapy with methylprednisolone bridging resulted in disease remission. The patient’s hair loss persisted, and he was diagnosed with AA. After his AA failed to respond to topical corticosteroids, his treatment was switched from vedolizumab to ustekinumab (390 mg intravenously at week 0, followed by 90 mg subcutaneously every 8 weeks). By week 24, marked scalp hair regrowth was evident, and by week 48, complete resolution of AA was achieved, while his CD remained in remission.ConclusionThis case suggests that ustekinumab may be a feasible therapeutic option for patients with coexisting CD and refractory AA, particularly when a shared IL-12/IL-23-mediated inflammatory pathway is suspected. Further prospective studies are required to confirm its efficacy and generalizability in this setting.
SN - 1664-3224
ER -