Resumen

CENTURION VILLALBA, Aramí María et al. Azathioprine-Induced Anagen Effluvium: A Report of a Rare Adverse Effect. An. Fac. Cienc. Méd. (Asunción) [online]. 2026, vol.59, n.1, e59012652.  Epub 21-Jul-2026. ISSN 1816-8949.  https://doi.org/10.18004/anales/2026.e59012652.

Azathioprine is an immunosuppressive drug widely used in autoimmune dermatological diseases. It is a purine analog that acts by inhibiting an enzyme involved in DNA synthesis, thereby affecting cellular proliferation. Adverse effects related to this mechanism of action include bone marrow suppression, hepatic abnormalities, oral ulcers, and, at the dermatological level, a few published cases of anagen effluvium. Some of these manifestations may be associated with low levels of the enzyme thiopurine methyltransferase, which is responsible for inactivating purine-derived metabolites. Anagen effluvium usually develops during the first weeks after the initiation of azathioprine therapy and is generally reversible following drug discontinuation. We report the case of a 36-year-old female patient with a diagnosis of dry eye syndrome, receiving hydroxychloroquine therapy and subsequently started on azathioprine 50 mg/day. She developed agranulocytosis requiring hospitalization and subsequently experienced diffuse hair loss two weeks after initiating the immunosuppressive therapy, without other associated predisposing factors, with a pattern suggestive of anagen effluvium. The patient showed a favorable clinical response after discontinuation of azathioprine and treatment with topical and oral minoxidil, with hair regrowth observed one month after the initiation of therapy. This case is of particular interest because of the limited number of published reports describing anagen effluvium associated with azathioprine use and the rapid and excellent response following withdrawal of the drug.

Palabras clave : azathioprine; hair diseases; alopecia.

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