A rare outcome following a bee sting: Total alopecia

Main Article Content

Ceren Kaplankıran https://orcid.org/0000-0002-0591-8094
Begüm Görgülü Akın https://orcid.org/0000-0002-6200-0909
Şadan Soyyiğit https://orcid.org/0000-0003-3270-5884

Keywords

Alopecia, bee sting, autoimmunity, paraneoplasia

Abstract

Following bee stings, multiple case reports have described the onset of autoimmune-related conditions, including myasthenia gravis, nephrotic syndrome, Henoch-Schönlein purpura, myocardial infarction, cerebrovascular events, and localized alopecia, typically within a few days, indicating that bee venom may play a role in triggering autoimmunity. We report a rare case of total alopecia occurring within ten days after a bee sting. While the literature includes one prior case of total alopecia following bee sting-induced anaphylaxis, our case is distinct in that the patient developed total alopecia in the absence of any hypersensitivity reactions, suggesting a potential immunomodulatory or exacerbating effect of the bee sting on the immune system.

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References

1 Wasserman D, Guzman-Sanchez DA, Scott K, McMichael A. Alopecia areata. Int J Dermatol. 2007;46(2):121–31. 10.1111/j.1365-4632.2007.03193.x

2 Colombe BW, Lou CD, Price VH. The genetic basis of alopecia areata: HLA associations with patchy alopecia areata versus alopecia totalis and alopecia universalis. J Investig Dermatol Symp Proc. 1999;4(3):216–9. 10.1038/sj.jidsp.5640214

3 Mortazavi M, Mansouri P. Ant-induced alopecia: Report of 2 cases and review of the literature. Dermatol Online J. 2004;10(1):19.

4 Sharma AK, Sharma RC, Sharma NL. Diffuse hair loss following multiple honeybee stings. Dermatology. 1997;195(3):305. 10.1159/000245972

5 Yilmaz C, Caksen H, Anlar Ö, Odabas D. Guillain-Barré syndrome following bee sting. J Pediatr Neurol. 2005;3(4):279–80. 10.1055/s-0035-1557276

6 Marks HG, Augustyn P, Allen RJ. Fisher’s syndrome in children. Pediatrics. 1977;60(5):726–9.

7 Kaarthigeyan K, Sivanandam S, Jothilakshmi K, Matthai J. Nephrotic syndrome following a single bee sting in a child. Indian J Nephrol. 2012;22(1):57–8. 10.4103/0971-4065.83742

8 Quercia O, Emiliani F, Foschi FG, Stefanini GF. Unusual reaction to hymenoptera sting: A case of Schönlein–Henoch purpura. Allergy. 2007;62(3):333–4. 10.1111/j.1398-9995.2006.01275.x

9 Gálvez-Olortegui J, Álvarez-Vargas M, Durand-Vergara J, Díaz-Lozano M, Gálvez-Olortegui T, Armas-Ramírez I, et al. Henoch Schonlein purpura associated with bee sting: Case report. Medwave. 2015;15(9):e6297. 10.5867/medwave.2015.09.6297

10 Lee HJ, Park IS, Lee JI, Kim JS. Guillain-Barré syndrome following bee venom acupuncture. Intern Med. 2015;54(8):975–8. 10.2169/internalmedicine.54.2238

11 Rho YH, Woo JH, Choi SJ, Lee YH, Ji JD, Song GG. A new onset of systemic lupus erythematosus developed after bee venom therapy. Korean J Intern Med. 2009;24(3):283–5. 10.3904/kjim.2009.24.3.283

12 Zhang SF, Chen Z. Melittin exerts an antitumor effect on non-small cell lung cancer cells. Mol Med Rep. 2017;16(3):3581–6. 10.3892/mmr.2017.6970

13 Atmaram V, Mathew A, Kurian G, Unni V. Acute renal failure following multiple wasp stings. Indian J Nephrol. 2005;15(1):30–2. 10.4103/0971-4065.34913

14 Daher Ede F, da Silva Júnior GB, Bezerra GP, Pontes LB, Martins AM, Guimarães JA. Acute renal failure after massive honeybee stings. Rev Inst Med Trop Sao Paulo. 2003;45(1): 45–50. 10.1590/s0036-46652003000100010

15 Xing L, Dai Z, Jabbari A, Cerise JE, Higgins CA, Gong W, et al. Alopecia areata is driven by cytotoxic T lymphocytes and is reversed by JAK inhibition. Nat Med. 2014;20(9):1043–9. 10.1038/nm.3645

16 Suárez-Fariñas M, Ungar B, Noda S, Shroff A, Mansouri Y, Fuentes-Duculan J, et al. Alopecia areata profiling shows TH1, TH2, and IL-23 cytokine activation without parallel TH17/TH22 skewing. J Allergy Clin Immunol. 2015;136(5):1277–87. 10.1016/j.jaci.2015.06.032

17 Renert-Yuval Y, Guttman-Yassky E. The changing landscape of alopecia areata: The therapeutic paradigm. Adv Ther. 2017;34(7):1594–609. 10.1007/s12325-017-0542-7

18 Tusiimire J, Wallace J, Woods N, Dufton MJ, Parkinson JA, Abbott G, et al. Effect of bee venom and its fractions on the release of pro-inflammatory cytokines in PMA-differentiated U937 cells co-stimulated with LPS. Vaccines (Basel). 2016;4(2):11. 10.3390/vaccines4020011

19 Cogan RC, Perlmutter JW, von Kuster K, Wiseman MC. Paraneoplastic alopecia areata surrounding a low-grade cutaneous carcinoma with squamous and trichoblastic features. JAAD Case Rep. 2021;18:8–11. 10.1016/j.jdcr.2021.09.038

20 Peter E, Dumez P, Honnorat J, Desestret V. Mechanisms of immune tolerance breakdown in paraneoplastic neurological syndromes. Rev Neurol (Paris). 2024;180(9):931–9. 10.1016/j.neurol.2024.08.002

21 Żeberkiewicz M, Rudnicka L, Malejczyk J. Immunology of alopecia areata. Cent Eur J Immunol. 2020;45(3):325–33. 10.5114/ceji.2020.101264