Alopecia Universalis: Never Give Up?

    February 2025 in “ PubMed ”
    Victoria Jiminez, Anna S. Riess, Tiffany Mayo, Boni Elewski
    From the encyclopedia
    Baricitinib →

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

    Alopecia Areata →

    autoimmune disorder causing patchy hair loss

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    Studysummary This case report observed successful hair regrowth with ritlecitinib in a patient with severe alopecia who did not respond to a previous year of baricitinib therapy. Our plain-language summary of this paper — not a Tressless recommendation.
    This case study highlights the successful use of prolonged Janus kinase inhibitor (JAKi) therapy in a 28-year-old female with alopecia universalis, who initially did not respond to baricitinib but experienced significant hair regrowth after switching to ritlecitinib. After 2 years of JAKi therapy, including 1 year on ritlecitinib, the patient showed robust regrowth of terminal hair on the scalp, eyelashes, and eyebrows, with a reduction in her Severity of Alopecia Tool (SALT) score from 100% to 17.2. The study suggests that dermatologists should consider longer courses of JAKi therapy and switching within the class for patients with severe refractory alopecia areata who do not respond to initial treatments.
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