O potencial terapêutico da hidroxicloroquina no tratamento de alopecias autoimunes
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Jul 19, 2025
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Objetivo: Analisar os tipos de alopecias autoimunes que se beneficiam com o uso de hidroxicloroquina. Métodos: Trata-se de uma Revisão Integrativa da Literatura, com buscas nas plataformas National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO), Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS), a Biblioteca Virtual em Saúde (BVS) e o Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), em que foram usados Descritores em Ciências da Saúde (DeCS) em inglês: "Hydroxychloroquine" AND "Alopecia". Com a aplicação dos critérios de inclusão e exclusão, foram selecionados 29 artigos que constituíram essa pesquisa. Resultados: Foi observado que a eficácia da hidroxicloroquina (HCQ) varia entre os tipos de alopecias autoimunes, sendo frequentemente combinada a outras terapias, e seu uso exige monitorização. O subtipo mais abordado nos estudos foi a alopecia fibrosante frontal, com destaque na estabilização do quadro, principalmente quando utilizada em combinação com outras terapias. Considerações finais: A HCQ mostrou maior eficácia em alopecias autoimunes cicatriciais, com estabilização inflamatória e perfil de segurança favorável, especialmente em uso prolongado e combinado. Já nas alopecias não cicatriciais, os resultados foram inconsistentes, restringindo seu uso a casos refratários.
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Como Citar
FrancelinoM. I. de C., Medeiros RolimL. A. D. M. de, SousaM. N. A. de, & CordeiroL. C. da C. (2025). O potencial terapêutico da hidroxicloroquina no tratamento de alopecias autoimunes. Revista Eletrônica Acervo Científico, 25, e20660. https://doi.org/10.25248/reac.e20660.2025
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Referências
1. AKDOGAN N e ERSOY‐EVANS S. Hydroxychloroquine treatment for Alopecia Universalis: Report of six cases. Australasian Journal of Dermatology, 2021; 62(1): 83-85.
2. AL ABOUD M, et al. Alopecia. In: StatPearls [Internet]. StatPearls Publishing, 2024.
3. BARTON V, et al. Treatment of pediatric alopecia areata: A systematic review. J Am Acad Dermatol, 2022; 86(6): 1318-1334.
4. BATRA P, et al. Hair loss in lichen planopilaris and frontal fibrosing alopecia: not always irreversible. Skin Appendage Disorders, 2020; 6(2): 125-129.
5. BRETAS T, et al. Flushing episodes in the context of frontal fibrosing alopecia with facial papules. BMJ Case Reports CP, 2021; 14(8): 242017.
6. BROSHTILOVA V, et al. Cicatricial alopecia-a case report with a review of literature. Scripta Scientifica Medica, 2018; 50(1): 41-44.
7. CID PM, et al. Alopecia frontal fibrosante: estudio retrospectivo de 75 pacientes. Actas Dermo-Sifiliográficas, 2020; 111(6): 487-495.
8. CONTIN L, et al. Frontal Fibrosing Alopecia Coexisting with Lupus Erythematosus: Poor Response to Hydroxychloroquine. Skin Appendage Disord, 2017; 2(3-4): 162-165.
9. DAŃCZAK-PAZDROWSKA A e POLAŃSKA A. The place of hydroxychloroquine in modern dermatology. Dermatology Review/Przegląd Dermatologiczny, 2021; 108(3): 178-190.
10. SOUSA MNA, et al. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. Observatorio de la economía latinoamericana, 2023; 21(10): 18448-18483.
11. DEL TORO NP, et al. Prevalence and treatment patterns in patients with lichen planopilaris. JAMA dermatology, 2024; 160(8): 865-868.
12. DINA Y e AGUH C. Algorithmic approach to the treatment of frontal fibrosing alopecia: a systematic review. Journal of the American Academy of Dermatology, 2021; 85(2): 508-510.
13. EZZAT R, et al. Frontal Fibrosing Alopecia Part II: Etiopathogenesis and Management. Journal of the American Academy of Dermatology, 2025.
14. FELTRINI M, et al. Alopecia frontal fibrosante: uma revisão de literatura. Revista foco, 2025; 18(3): 7938.
15. FERTIG R, et al. Therapeutic options in frontal fibrosing alopecia. Expert Opinion on Orphan Drugs, 2016; 4(5): 461-468.
16. FERTIG R e TOSTI A. Frontal fibrosing alopecia treatment options. Intractable & rare diseases research, 2016; 5(4): 314-315.
17. GAMRET AC, et al. Frontal fibrosing alopecia: efficacy of treatment modalities. International Journal of Women's Health, 2019; 273-285.
18. GISONDI P, et al. The safety profile of hydroxychloroquine: major cutaneous and extracutaneous adverse events. Clin Exp Rheumatol, 2021; 39(5): 1099-1107.
19. HE X, et al. A case of neuropsychiatric systemic lupus erythematosus with hair loss as the first diagnostic symptom. Frontiers in Psychiatry, 2022; 13: 839566.
20. HUO R, et al. Hydroxychloroquine: A double edged sword. Molecular Medicine Reports, 2025; 31(4): 1-11.
21. JAMBUSAYEE J e SUDHA KM. A randomised, open label comparative study of hydroxychloroquine with betamethasone oral mini pulse in the management of patients with alopecia areata. International Journal of Basic & Clinical Pharmacology, 2021; 10(2): 187-193.
22. JIAN X, et al. Systemic lupus erythematosus complicated by anti-MDA5 antibody-positive juvenile dermatomyositis: A rare overlap syndrome in childhood. Rheumatology & Autoimmunity, 2025; 5(1): 71-72.
23. KĘPIŃSKA K, et al. Fibrosing Alopecia - a review and a practical guide for clinicians. Ann Agric Environ Med, 2022; 29(2): 169-184.
24. KŁOSOWICZ A, et al. Dendritic cells as predictive markers of responsiveness to hydroxychloroquine treatment in primary cicatricial alopecia patients. Dermatologic Therapy, 2020; 33(6): 14509.
25. LIANG KR, et al. Resolution of Discoid Lupus Alopecia With Systemic Hydroxychloroquine and Topical Pimecrolimus Combination Therapy. Cureus, 2024; 16(6): 63419.
26. LIPNER SR e WANG Y. Retrospective analysis of dermatologic adverse events associated with hydroxychloroquine reported to the US Food and Drug Administration. Journal of the American Academy of Dermatology, 2020; 83(5): 1527.
27. LYAKHOVITSKY A, et al. A case series of 46 patients with lichen planopilaris: demographics, clinical evaluation, and treatment experience. Journal of Dermatological Treatment, 2015; 26(3): 275-279.
28. MARDONES F e SHAPIRO J. Lichen planopilaris in a Latin American (Chilean) population: demographics, clinical profile and treatment experience. Clinical and Experimental Dermatology, 2017; 42(7): 755-759.
29. NAEINI FF, et al. Clinical efficacy and safety of methotrexate versus hydroxychloroquine in preventing lichen planopilaris progress: a randomized clinical trial. International Journal of Preventive Medicine, 2017; 8(1): 37.
30. NISSEN CV e WULF HC. Hydroxychloroquine is ineffective in treatment of alopecia totalis and extensive alopecia areata: a case series of 8 patients. JAAD Case Reports, 2016; 2(2): 117-118.
31. OSMAN S e TRABOULSI D. Hydroxychloroquine for granuloma annulare: A case report on secondary hair growth in alopecia universalis. SAGE Open Medical Case Reports, 2023; 11: 2050313X231152066.
32. ÖZCAN D, et al. Lichen planopilaris: Demographic, clinical and histopathological characteristics and treatment outcomes of 25 cases. Turkderm - Arch Turk Dermatol Venerology, 2015; 49(246): 52.
33. PAUDEL V, et al. Alopecia Universalis Associated with Hyperthyroidism Treated with Azathioprine and Hydroxychloroquine: A Case Report. JNMA J Nepal Med Assoc, 2021; 59(241): 935-937.
34. QI JI e GARZA LA. An overview of alopecias. Cold Spring Harbor perspectives in medicine, 2014; 4(3): 13615.
35. RAVIPATI A, et al. Use of Hydroxychloroquine in Hair Disorders. Skin appendage disorders, 2023; 9(6): 416-422.
36. REAGIN H, et al. Linear Cutaneous Lupus Erythematosus Following Blaschko’s Lines on the Scalp: Additional Cases and Review of the Literature. HCA Healthcare Journal of Medicine, 2022; 3(2): 51.
37. RYPKA K J, et al. A single-center retrospective cohort study of hydroxychloroquine-related adverse events in adults with lymphocytic cicatricial alopecia. Journal of the American Academy of Dermatology, 2025; 92(4): 932-934.
38. SABER M, et al. Clinical effectiveness of finasteride versus hydroxychloroquine in the treatment of frontal fibrosing alopecia: A randomized controlled trial. Journal of Cosmetic Dermatology, 2024; 23(2): 576-584.
39. SANTANA VVR, et al. Revisão integrativa de literatura fatores de risco para o agravamento da Covid-19 em indivíduos jovens. Enfermagem em Foco, 2020; 11(2): 37-45.
40. SEO H, et al. Dutasteride in the treatment of frontal fibrosing alopecia: systematic review and meta‐analysis. Journal of the European Academy of Dermatology and Venereology, 2024; 38(8): 1514-1521.
41. SHARMA AN, et al. Characterizing the adverse dermatologic effects of hydroxychloroquine: a systematic review. Journal of the American Academy of Dermatology, 2020; 83(2): 563-578.
42. STEGE H, et al. Treatment of Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective, Real-Life Analysis in a Tertiary Center in Germany. Journal of Clinical Medicine, 2024; 13(16): 4947.
43. SUCHONWANIT P, et al. Frontal fibrosing alopecia in Asians: a retrospective clinical study. International Journal of Dermatology, 2020; 59(2): 184-190.
44. SUGIMOTO T, et al. Successful hydroxychloroquine treatment in a patient with systemic lupus erythematosus-associated nailfold capillary abnormalities. Rheumatology Advances in Practice, 2020; 4(2).
45. ¬SULEMAN-RAZA Y, et al. OA08 Ocrelizumab in pregnancy in a patient with juvenile onset systemic lupus erythematosus. Rheumatology Advances in Practice, 2024; 8(1): 117-118.
46. TAKEZAWA K, et al. Successful treatment with hydroxychloroquine for systemic lupus erythematosus with cutaneous involvement accompanied by a xanthomatous reaction. Lupus, 2020; 29(1): 79-82.
47. TAVAKOLPOUR S, et al. Frontal fibrosing alopecia: An update on the hypothesis of pathogenesis and treatment. International journal of women's dermatology, 2019; 5(2): 116-123.
48. TRÜEB RM e DIAS M. Alopecia areata: a comprehensive review of pathogenesis and management. Clinical reviews in allergy & immunology, 2018; 54: 68-87.
49. TRÜEB RM, et al. Cutaneous lupus erythematosus presenting as frontal fibrosing alopecia: report of 2 patients. Skin Appendage Disorders, 2017; 3(4): 205-210.
50. VALDEZ-ZERTUCHE J, et al. Efficacy, safety and tolerability of drugs for alopecia: a comprehensive review. Expert Opinion on Drug Metabolism & Toxicology, 2025.
51. WATSON VE, et al. Immune-mediated alopecias and their mechanobiological aspects. Cells & development, 2022; 170: 203793.
52. ZBICIAK-NYLEC M, et al. The efficacy of antimalarial drugs in the therapy of selected forms of cicatricial alopecia. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 2021; 38(2): 302-309.
2. AL ABOUD M, et al. Alopecia. In: StatPearls [Internet]. StatPearls Publishing, 2024.
3. BARTON V, et al. Treatment of pediatric alopecia areata: A systematic review. J Am Acad Dermatol, 2022; 86(6): 1318-1334.
4. BATRA P, et al. Hair loss in lichen planopilaris and frontal fibrosing alopecia: not always irreversible. Skin Appendage Disorders, 2020; 6(2): 125-129.
5. BRETAS T, et al. Flushing episodes in the context of frontal fibrosing alopecia with facial papules. BMJ Case Reports CP, 2021; 14(8): 242017.
6. BROSHTILOVA V, et al. Cicatricial alopecia-a case report with a review of literature. Scripta Scientifica Medica, 2018; 50(1): 41-44.
7. CID PM, et al. Alopecia frontal fibrosante: estudio retrospectivo de 75 pacientes. Actas Dermo-Sifiliográficas, 2020; 111(6): 487-495.
8. CONTIN L, et al. Frontal Fibrosing Alopecia Coexisting with Lupus Erythematosus: Poor Response to Hydroxychloroquine. Skin Appendage Disord, 2017; 2(3-4): 162-165.
9. DAŃCZAK-PAZDROWSKA A e POLAŃSKA A. The place of hydroxychloroquine in modern dermatology. Dermatology Review/Przegląd Dermatologiczny, 2021; 108(3): 178-190.
10. SOUSA MNA, et al. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. Observatorio de la economía latinoamericana, 2023; 21(10): 18448-18483.
11. DEL TORO NP, et al. Prevalence and treatment patterns in patients with lichen planopilaris. JAMA dermatology, 2024; 160(8): 865-868.
12. DINA Y e AGUH C. Algorithmic approach to the treatment of frontal fibrosing alopecia: a systematic review. Journal of the American Academy of Dermatology, 2021; 85(2): 508-510.
13. EZZAT R, et al. Frontal Fibrosing Alopecia Part II: Etiopathogenesis and Management. Journal of the American Academy of Dermatology, 2025.
14. FELTRINI M, et al. Alopecia frontal fibrosante: uma revisão de literatura. Revista foco, 2025; 18(3): 7938.
15. FERTIG R, et al. Therapeutic options in frontal fibrosing alopecia. Expert Opinion on Orphan Drugs, 2016; 4(5): 461-468.
16. FERTIG R e TOSTI A. Frontal fibrosing alopecia treatment options. Intractable & rare diseases research, 2016; 5(4): 314-315.
17. GAMRET AC, et al. Frontal fibrosing alopecia: efficacy of treatment modalities. International Journal of Women's Health, 2019; 273-285.
18. GISONDI P, et al. The safety profile of hydroxychloroquine: major cutaneous and extracutaneous adverse events. Clin Exp Rheumatol, 2021; 39(5): 1099-1107.
19. HE X, et al. A case of neuropsychiatric systemic lupus erythematosus with hair loss as the first diagnostic symptom. Frontiers in Psychiatry, 2022; 13: 839566.
20. HUO R, et al. Hydroxychloroquine: A double edged sword. Molecular Medicine Reports, 2025; 31(4): 1-11.
21. JAMBUSAYEE J e SUDHA KM. A randomised, open label comparative study of hydroxychloroquine with betamethasone oral mini pulse in the management of patients with alopecia areata. International Journal of Basic & Clinical Pharmacology, 2021; 10(2): 187-193.
22. JIAN X, et al. Systemic lupus erythematosus complicated by anti-MDA5 antibody-positive juvenile dermatomyositis: A rare overlap syndrome in childhood. Rheumatology & Autoimmunity, 2025; 5(1): 71-72.
23. KĘPIŃSKA K, et al. Fibrosing Alopecia - a review and a practical guide for clinicians. Ann Agric Environ Med, 2022; 29(2): 169-184.
24. KŁOSOWICZ A, et al. Dendritic cells as predictive markers of responsiveness to hydroxychloroquine treatment in primary cicatricial alopecia patients. Dermatologic Therapy, 2020; 33(6): 14509.
25. LIANG KR, et al. Resolution of Discoid Lupus Alopecia With Systemic Hydroxychloroquine and Topical Pimecrolimus Combination Therapy. Cureus, 2024; 16(6): 63419.
26. LIPNER SR e WANG Y. Retrospective analysis of dermatologic adverse events associated with hydroxychloroquine reported to the US Food and Drug Administration. Journal of the American Academy of Dermatology, 2020; 83(5): 1527.
27. LYAKHOVITSKY A, et al. A case series of 46 patients with lichen planopilaris: demographics, clinical evaluation, and treatment experience. Journal of Dermatological Treatment, 2015; 26(3): 275-279.
28. MARDONES F e SHAPIRO J. Lichen planopilaris in a Latin American (Chilean) population: demographics, clinical profile and treatment experience. Clinical and Experimental Dermatology, 2017; 42(7): 755-759.
29. NAEINI FF, et al. Clinical efficacy and safety of methotrexate versus hydroxychloroquine in preventing lichen planopilaris progress: a randomized clinical trial. International Journal of Preventive Medicine, 2017; 8(1): 37.
30. NISSEN CV e WULF HC. Hydroxychloroquine is ineffective in treatment of alopecia totalis and extensive alopecia areata: a case series of 8 patients. JAAD Case Reports, 2016; 2(2): 117-118.
31. OSMAN S e TRABOULSI D. Hydroxychloroquine for granuloma annulare: A case report on secondary hair growth in alopecia universalis. SAGE Open Medical Case Reports, 2023; 11: 2050313X231152066.
32. ÖZCAN D, et al. Lichen planopilaris: Demographic, clinical and histopathological characteristics and treatment outcomes of 25 cases. Turkderm - Arch Turk Dermatol Venerology, 2015; 49(246): 52.
33. PAUDEL V, et al. Alopecia Universalis Associated with Hyperthyroidism Treated with Azathioprine and Hydroxychloroquine: A Case Report. JNMA J Nepal Med Assoc, 2021; 59(241): 935-937.
34. QI JI e GARZA LA. An overview of alopecias. Cold Spring Harbor perspectives in medicine, 2014; 4(3): 13615.
35. RAVIPATI A, et al. Use of Hydroxychloroquine in Hair Disorders. Skin appendage disorders, 2023; 9(6): 416-422.
36. REAGIN H, et al. Linear Cutaneous Lupus Erythematosus Following Blaschko’s Lines on the Scalp: Additional Cases and Review of the Literature. HCA Healthcare Journal of Medicine, 2022; 3(2): 51.
37. RYPKA K J, et al. A single-center retrospective cohort study of hydroxychloroquine-related adverse events in adults with lymphocytic cicatricial alopecia. Journal of the American Academy of Dermatology, 2025; 92(4): 932-934.
38. SABER M, et al. Clinical effectiveness of finasteride versus hydroxychloroquine in the treatment of frontal fibrosing alopecia: A randomized controlled trial. Journal of Cosmetic Dermatology, 2024; 23(2): 576-584.
39. SANTANA VVR, et al. Revisão integrativa de literatura fatores de risco para o agravamento da Covid-19 em indivíduos jovens. Enfermagem em Foco, 2020; 11(2): 37-45.
40. SEO H, et al. Dutasteride in the treatment of frontal fibrosing alopecia: systematic review and meta‐analysis. Journal of the European Academy of Dermatology and Venereology, 2024; 38(8): 1514-1521.
41. SHARMA AN, et al. Characterizing the adverse dermatologic effects of hydroxychloroquine: a systematic review. Journal of the American Academy of Dermatology, 2020; 83(2): 563-578.
42. STEGE H, et al. Treatment of Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective, Real-Life Analysis in a Tertiary Center in Germany. Journal of Clinical Medicine, 2024; 13(16): 4947.
43. SUCHONWANIT P, et al. Frontal fibrosing alopecia in Asians: a retrospective clinical study. International Journal of Dermatology, 2020; 59(2): 184-190.
44. SUGIMOTO T, et al. Successful hydroxychloroquine treatment in a patient with systemic lupus erythematosus-associated nailfold capillary abnormalities. Rheumatology Advances in Practice, 2020; 4(2).
45. ¬SULEMAN-RAZA Y, et al. OA08 Ocrelizumab in pregnancy in a patient with juvenile onset systemic lupus erythematosus. Rheumatology Advances in Practice, 2024; 8(1): 117-118.
46. TAKEZAWA K, et al. Successful treatment with hydroxychloroquine for systemic lupus erythematosus with cutaneous involvement accompanied by a xanthomatous reaction. Lupus, 2020; 29(1): 79-82.
47. TAVAKOLPOUR S, et al. Frontal fibrosing alopecia: An update on the hypothesis of pathogenesis and treatment. International journal of women's dermatology, 2019; 5(2): 116-123.
48. TRÜEB RM e DIAS M. Alopecia areata: a comprehensive review of pathogenesis and management. Clinical reviews in allergy & immunology, 2018; 54: 68-87.
49. TRÜEB RM, et al. Cutaneous lupus erythematosus presenting as frontal fibrosing alopecia: report of 2 patients. Skin Appendage Disorders, 2017; 3(4): 205-210.
50. VALDEZ-ZERTUCHE J, et al. Efficacy, safety and tolerability of drugs for alopecia: a comprehensive review. Expert Opinion on Drug Metabolism & Toxicology, 2025.
51. WATSON VE, et al. Immune-mediated alopecias and their mechanobiological aspects. Cells & development, 2022; 170: 203793.
52. ZBICIAK-NYLEC M, et al. The efficacy of antimalarial drugs in the therapy of selected forms of cicatricial alopecia. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 2021; 38(2): 302-309.