Paudel, VikashChudal, DeepaPradhan, Manish BhaktaThakur, RupaPandey, Buddhi Raj2026-02-172026-02-172021https://hdl.handle.net/20.500.14572/4799Vikash Paudel Department of Dermatology, National Medical College, Birgunj, Nepal https://orcid.org/0000-0001-8729-052X Deepa Chudal Deputy superintendent of police, Nepal Police Hospital, Maharajgunj, Kathmandu, Nepal https://orcid.org/0000-0003-0610-3214 Manish Bhakta Pradhan Department of Dermatology, National Medical College, Birgunj, Nepal https://orcid.org/0000-0001-5220-6113 Rupa Thakur Department of Dermatology, National Medical College, Birgunj, Nepal Buddhi Raj Pandey Department of Dermatology, National Medical College, Birgunj, NepalAbstract: Alopecia universalis is an uncommon form of alopecia areata involving hair loss over the entire scalp and body. This condition is difficult to treat and sustain the growth of hair for longer duration. We report a case of alopecia universalis associated with severe hyperthyroidism. A lady in her fourth decade presented to us with gradual onset of alopecia universalis, who later found to have hyperthyroidism which was refractory to multiple treatment modalities. She was treated successfully with azathioprine and hydroxychloroquine. Alopecia universalis with less response to oral steroid therapy was successfully managed with azathioprine with hydroxychloroquine.en-USalopecia areataalopecia universalisazathioprinehydroxychloroquineArticle