Hydroxychloroquine is ineffective in treatment of alopecia totalis and extensive alopecia areata: A case series of 8 patients

In June 2013, the Journal of the American Academy of Dermatology published a report concerning successful treatment of 2 cases of alopecia totalis with hydroxychloroquine.1 This report was encouraging, as treatment of alopecia totalis is challenging and in most cases unsuccessful. The authors explained their results with the wide range of immunomodulatory effects that are attributed to hydroxychloroquine.2 These effects include decreased secretion of proinflammatory cytokines and reduced production of lymphocytes and autoantibodies.3 As a consequence of their results, we investigated hydroxychloroquine treatment for extensive alopecia in a larger cohort.