Alopecia Areata: Case Report and Review of Pathophysiology and Treatment with JAK Inhibitors

A 58-year-old man with a history of various health conditions developed sudden alopecia areata (AA), losing 70% of his scalp hair and experiencing beard and body hair loss. AA is an autoimmune disease where T-cells attack hair follicles, leading to hair loss that can progress to alopecia totalis or universalis. The pathophysiology involves the JAK/STAT pathway, with cytokines like interferon gamma playing a key role. JAK inhibitors, such as tofacitinib and baricitinib, have shown promise in treating severe AA, with studies reporting significant hair regrowth. Side effects of JAK inhibitors are generally mild, but there are concerns about long-term safety. The patient's case highlights the potential for JAK inhibitors in managing AA, despite the lack of inflammatory infiltrate in his biopsy.