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Our search strategy identified 96 patients from 45 studies in addition to our own case. Our review indicates a higher prevalence of paradoxical psoriatic alopecia in younger female patients, most commonly secondary to TNF\u2010alpha inhibitors. Unlike alopecia secondary to psoriasis vulgaris, a mixed inflammatory infiltrate featuring lymphocytes, plasma cells and eosinophils was observed. Remission was observed in most patients, including approximately a third of whom continued biologic therapy.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    PROSPERO registration number: CRD42023471174\n                  <\/jats:p>","DOI":"10.1111\/ajd.14600","type":"journal-article","created":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T06:21:09Z","timestamp":1757744469000},"page":"441-447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Biologic\u2010Induced Paradoxical Psoriatic Alopecia: A Systematic Review"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1547-8715","authenticated-orcid":false,"given":"Yaron","family":"Gu","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health The University of New South Wales  Kensington New South Wales Australia"},{"name":"Department of Dermatology Liverpool Hospital  Liverpool New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5896-8178","authenticated-orcid":false,"given":"Deshan F.","family":"Sebaratnam","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of New South Wales  Kensington New South Wales Australia"},{"name":"Department of Dermatology Liverpool Hospital  Liverpool New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6200-0055","authenticated-orcid":false,"given":"Mani","family":"Makhija","sequence":"additional","affiliation":[{"name":"Kossard Dermatopathologists  Macquarie Park New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6531-9360","authenticated-orcid":false,"given":"Joshua","family":"Farrell","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of New South Wales  Kensington New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-318484"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.13141"},{"key":"e_1_2_11_4_1","first-page":"161","article-title":"Hidradenitis Suppurativa, a Review of Pathogenesis, Associations and Management. 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