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

November 2022 in “ Journal of autoimmunity ”

Isabelle Paggioli, Jeremy Moss

alopecia areata T-cells hair follicles alopecia totalis alopecia universalis JAK/STAT pathway cytokines interferon gamma JAK inhibitors tofacitinib baricitinib AA Xeljanz Olumiant

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Tofacitinib →

a JAK inhibitor for alopecia areata and other autoimmune conditions

Baricitinib →

JAK inhibitor that reduces inflammation and immune attacks on hair follicles, leading to potential hair regrowth, especially in alopecia areata cases

Studysummary This case report discusses a successful treatment of Alopecia Areata with tofacitinib and includes a literature review on the condition's pathophysiology and the mechanism of JAK inhibitors, though it notes the high failure rate of available treatments and absence of FDA-approved options. Our plain-language summary of this paper — not a Tressless recommendation.

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.

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