Longitudinal Clinical Course, Treatment Outcomes, and Relapse Patterns in Alopecia Areata: A Prospective Cohort Study

November 2025 in “ Frontiers in Medicine ”

Wenjie Yan, Yue Wang, Mengjiao Wang, Zhao Yu-mei, Xi Huang

alopecia areata baseline severity disease activity relapse history standardized severity scores patient-reported outcomes imaging biomarkers AA

Studysummary In this prospective cohort, baseline severity, disease activity, and relapse history were identified as key factors influencing response and recurrence in alopecia areata, suggesting that implementing standardized assessments could enhance risk stratification and personalized care approaches.

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research Global Burden of Alopecia Areata from 1990 to 2019 and Emerging Treatment Trends Analyzed Through GBD 2019 and Bibliometric Data

5 citations , July 2025 in “Scientific Reports”

This study observed that areas with low socio-demographic index showed the greatest rise in the disease burden of alopecia areata from 1990 to 2019, while high SDI areas still carried the highest burden overall.

research Immune-Mediated Disorders in Patients With Alopecia Areata: Systematic Review and Meta-Analysis

7 citations , July 2025 in “International Journal of Dermatology”

This meta-analysis found that patients with alopecia areata have significantly higher odds of also having immune-mediated diseases such as atopic dermatitis, autoimmune thyroiditis, inflammatory bowel disease, systemic lupus erythematosus, and vitiligo, suggesting a need for comprehensive screening and interdisciplinary management.

research Lessons from TNF-Alpha Inhibitor-Induced Alopecia Areata: Does TNF-Alpha Operate as a Hair Follicle Immune Privilege Guardian Under Inflammatory Conditions?

2 citations , June 2025 in “Journal of Investigative Dermatology”

research Predominance of CD27-PD-1- Effector Memory T Cells Re-Expressing CD45RA Characterizes Treatment-Resistant Severe Alopecia Areata

2 citations , June 2025 in “Journal of Investigative Dermatology”

CD8+ T cells re-expressing CD45RA may predict treatment resistance in severe alopecia areata.

research Serum-Based Assessment of Alopecia Areata Response to Treatment Using ATR-FTIR Spectroscopy

2 citations , May 2025 in “Diagnostics”

This study found that ATR-FTIR spectroscopy combined with machine learning effectively differentiated alopecia areata patients from healthy controls with an AUC of 0.85, and also showed promise in predicting treatment response, particularly through alterations in the Amide I band.

research Innovative Approaches to the Assessment of Alopecia Areata: Incorporating the SALT Index Through Transparent Devices

1 citations , May 2025 in “International Journal of Dermatology”

research SALT Score Distribution With Ritlecitinib Treatment Up to 24 Months in Alopecia Areata

2 citations , May 2025 in “Journal of the European Academy of Dermatology and Venereology”

In this study, daily treatment with ritlecitinib for up to 24 months led to significant reductions in high-severity alopecia areata SALT scores among patients aged ≥12 years, including those with severe forms such as alopecia totalis and universalis.

Real-World Evidence for Baricitinib in the Treatment of Atopic Dermatitis and Alopecia Areata: Systematic Literature Review 2020–2023

research Real-World Evidence for Baricitinib in the Treatment of Atopic Dermatitis and Alopecia Areata: Systematic Literature Review 2020–2023

4 citations , May 2025 in “Dermatology and Therapy”

This study found that baricitinib improved symptoms of atopic dermatitis and alopecia areata in both adults and children in real-world settings, aligning with clinical trial results, while noting low discontinuation due to adverse events and no new safety concerns.

research Unveiling the Immune and Vitamin Profiles of Blood: Potential Biomarkers for Alopecia Areata

May 2025 in “PeerJ”

This study observed that, among alopecia areata patients in Fujian, China, lower IgG4 levels and higher IFN-γ levels were statistically significant, suggesting their potential role as biomarkers for the condition and highlighting avenues for future therapeutic developments.

research Safety of Baricitinib in Adults with Severe Alopecia Areata from Two Phase III Trials Over a Median of 2.3 Years and Up to 4 Years of Treatment

3 citations , April 2025 in “American Journal of Clinical Dermatology”

Baricitinib is generally safe for long-term use in treating severe alopecia areata.

research Evaluation of SALT Score Severity in Correlation With Trichoscopic Findings in Alopecia Areata: A Study of 303 Patients

7 citations , March 2025 in “Archives of Dermatological Research”

This study found that trichoscopy is essential for evaluating the severity of alopecia areata and predicting treatment responses, contributing to more personalized patient management.

research Switching JAK Inhibitors: Evaluating Baricitinib’s Effectiveness in Alopecia Areata After Tofacitinib Failure

2 citations , February 2025 in “Archives of Dermatological Research”

This retrospective study observed that switching from tofacitinib to baricitinib improved hair growth in patients with alopecia areata, particularly for previous non-responders, and noted fewer side effects with baricitinib.

research Dual Improvement of Alopecia Areata and Immune Thrombocytopenia With Baricitinib: A Case Report

January 2025 in “Skin Health and Disease”

In this report, oral baricitinib improved both alopecia areata and immune thrombocytopenia in a 56-year-old patient, suggesting a potential dual benefit for these conditions, although regular platelet monitoring and hematology consultation are recommended.

research Identifying Effective Immune Biomarkers in Alopecia Areata Diagnosis Based on Machine Learning Methods

3 citations , January 2025 in “BMC Medical Informatics and Decision Making”

This study suggests that novel diagnostic, preventive, and treatment approaches for autoimmune diseases like alopecia areata may be developed by identifying hub genes, and highlights the usefulness of machine learning and bioinformatics in finding new disease biomarkers.

research Complete Responses And SALT Zero Scores In Alopecia Areata: Not The Same

1 citations , November 2024 in “Journal of Dermatological Treatment”

Significant hair regrowth doesn't always mean complete hair recovery in alopecia areata.

research Predictors And Management Of Inadequate Response To JAK Inhibitors In Alopecia Areata

11 citations , September 2024 in “American Journal of Clinical Dermatology”

Switching JAK inhibitors or using dupilumab may help some alopecia areata patients who don't respond well to initial treatments.

research Comparative Efficacy and Safety of Systemic Steroids, Oral JAK Inhibitors, and Contact Immunotherapy in the Treatment of Severe Alopecia Areata: A Systematic Review and Network Meta-Analysis

3 citations , July 2024 in “Archives of Dermatological Research”

This study found that oral dexamethasone and DPCP were more effective for treating severe alopecia areata compared to oral ritlecitinib and baricitinib, but oral ritlecitinib had better safety outcomes.

research A Review of JAK Inhibitors for Treatment of Alopecia Areata in the Military Health Care System

June 2024 in “Military medicine”

This review explored treatment options for alopecia areata in the military health care system, evaluating the pathogenesis and impact of the condition as well as the efficacy and safety of FDA-approved JAK inhibitors, baricitinib and ritlecitinib.

research Retracted: Causal Role of Immune Cells in Alopecia Areata: A Two-Sample Mendelian Randomization Study

14 citations , January 2024 in “Skin Research and Technology”

The study suggested certain immune cells might cause alopecia areata, but it was retracted.

Construction of Regulatory Network for Alopecia Areata Progression and Identification of Immune Monitoring Genes Based on Multiple Machine-Learning Algorithms

research Construction of Regulatory Network for Alopecia Areata Progression and Identification of Immune Monitoring Genes Based on Multiple Machine-Learning Algorithms

3 citations , May 2023 in “Precision clinical medicine”

This study analyzed gene expression data to identify key genes involved in severe forms of alopecia areata, discovering four immune monitoring genes (LGR5, SHISA2, HOXC13, S100A3) with potential for early diagnosis and better understanding of the disease's biological mechanisms.

research Trends in Prevalence and Incidence of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis Among Adults and Children in a US Employer-Sponsored Insured Population

75 citations , March 2023 in “JAMA Dermatology”

This study reported that the prevalence of alopecia areata in the US slightly increased from 0.199% to 0.222% between 2016 and 2019, with higher rates observed in women and adults.

research Prevalence of Alopecia Areata in Japan: Estimates from a Nationally Representative Sample

18 citations , November 2022 in “The Journal of Dermatology”

This study in Japan identified an estimated prevalence of alopecia areata between 1.45% and 2.18%, highlighting a significant psychological burden and potential unmet need for treatment among affected individuals.

research Prevalence, Comorbidities, and Treatment Patterns of Japanese Patients with Alopecia Areata: A Descriptive Study Using Japan Medical Data Center Claims Database

35 citations , November 2022 in “The Journal of Dermatology”

This study found that the prevalence of alopecia areata in Japan increased from 2012 to 2019, with allergic diseases as common comorbidities and a need for more effective treatments, particularly for severe and pediatric cases.

research Alopecia Areata as an Immune-Related Adverse Event Associated with Response to Immune Checkpoint Inhibitors

3 citations , July 2022 in “European Journal of Dermatology”

In this study, researchers using multistate modeling reported that patients with psoriasis treated with brodalumab had a higher probability of achieving and maintaining a therapeutic response compared to those treated with ustekinumab over 52 weeks, based on absolute PASI measurements.

research Prevalence and Risk Factors Associated with the Occurrence of Autoimmune Diseases in Patients with Alopecia Areata

14 citations , September 2021 in “Journal of Inflammation Research”

This study suggests that female patients with alopecia areata, especially those with nail abnormalities and atopic diseases, may have higher rates of coexisting autoimmune diseases.

Tofacitinib for the Treatment of Three Immune-Mediated Conditions in One Patient: Ulcerative Colitis, Pyoderma Gangrenosum, and Alopecia Areata

research Tofacitinib for the Treatment of Three Immune-Mediated Conditions in One Patient: Ulcerative Colitis, Pyoderma Gangrenosum, and Alopecia Areata

5 citations , January 2021 in “Inflammatory Bowel Diseases”

In this report, a female patient with ulcerative colitis, alopecia areata, and pyoderma gangrenosum showed improvement in all three conditions after being treated with tofacitinib.

research A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States

63 citations , March 2020 in “Clinical Cosmetic and Investigational Dermatology”

This study suggests that the prevalence of alopecia areata in the US remains similar to high estimates from the 1970s, with significant implications for quality of life.

research Epigallocatechin-3 Gallate Inhibits STAT-1/JAK2/IRF-1/HLA-DR/HLA-B and Reduces CD8 NKG2D Lymphocytes in Alopecia Areata Patients

15 citations , December 2018 in “International journal of environmental research and public health/International journal of environmental research and public health”

This study observed that Epigallocatechin-3-gallate (EGCG) can inhibit phosphorylation of STAT1 and reduce a specific subset of immune cells in vitro and ex vivo, suggesting a potential role in maintaining immune privilege in alopecia areata.

research High-Throughput T Cell Receptor Sequencing Identifies Clonally Expanded CD8+ T Cell Populations in Alopecia Areata

46 citations , October 2018 in “JCI insight”

In this study, the researchers found that treatment with the JAK inhibitor tofacitinib in alopecia areata patients may reduce clonal CD8+ T cell expansions but does not eliminate them entirely, which could contribute to disease relapse.

research Quantifying Alopecia Areata via Texture Analysis to Automate the SALT Score Computation

20 citations , December 2017 in “Journal of Investigative Dermatology Symposium Proceedings”

This article presents a computer imaging algorithm that may automate and enhance the Severity of Alopecia Tool scoring for alopecia areata through texture analysis of pediatric images.

research SOCS3 Treatment Prevents the Development of Alopecia Areata by Inhibiting CD8+ T Cell-Mediated Autoimmune Destruction

16 citations , March 2017 in “Oncotarget”

This study suggests that SOCS3 treatment may effectively inhibit alopecia areata by suppressing CD8+ T cell activity and IFN-γ production.

research CD8-Positive Mycosis Fungoides Clinically Masquerading as Alopecia Areata

8 citations , August 2016 in “Journal of Cutaneous Pathology”

This case report highlights a rare instance of CD8-positive hypopigmented mycosis fungoides causing alopecia areata-like changes, emphasizing the necessity of scalp biopsy in such presentations.

research Human Leukocyte Antigen Class II Alleles Are Associated with Risk of Alopecia Areata

36 citations , July 2007 in “Journal of Investigative Dermatology”

This study observed a strong negative association between the HLA-DQB1*0201 allele and the alopecia totalis/alopecia universalis phenotype in Caucasian individuals, indicating a potential protective role.