Sir, Efalizumab is a recombinant humanized IgG_1 monoclonal antibody against the CD11a molecule approved for the treatment of moderate to severe psoriasis. Hypertrichosis is a cosmetic disorder that involves a vellus to terminal switch in body regions that do not usually bear terminal hairs. Many drugs have been implicated in the development of localized or generalized hypertrichosis but to our knowledge this is the first case of efalizumab-induced hypertrichosis.A 68-year-old woman with recalcitrant psoriasis unresponsive to topical corticoids, calcipotriol and to systemic acitretin, methotrexate and etanercept, was administered efalizumab l.0 mg kg~(-1) once a week. Approximately 4 weeks after her first injection, excessive hair growth was observed on the face (Fig. 1), scalp, eyebrows and the subsiding psoriatic plaques of the calves. An increase in lymphocyte count with normal total white blood cell count was also noticed.Her psoriasis had responded partially to efalizumab, and thus the patient didnot consent to cessation of the therapy. Laboratory investigation revealed an increase in free testosterone levels 3.89 pg mL~(-1) (normal 0.3-3.2). A computerized tomography scan of the upper abdomen was normal and 24-h urinary free cortisol levels were within normal ranges.
展开▼
