Alopecia Universalis: Partial Response to Tofacitinib

The document reports a case of a 43-year-old male patient with Alopecia areata universalis (AA) and moderate psoriasis, who had not responded to conventional treatments for AA, including high-potency corticosteroids, diphenciprone, 5% minoxidil, intralesional corticosteroids, and dexamethasone. The patient was treated with tofacitinib, a janus kinase inhibitor approved for rheumatoid arthritis, at a dose of 5 mg every 12 hours. After three months, minimal hair regrowth was observed in the occipital area, and by six months, there was a 40% repopulation of the previously lost hair, significantly improving the patient's quality of life. No side effects were reported after six months of treatment. The document suggests that tofacitinib is a promising treatment for AA, but discontinuation may reverse its effects. It calls for better quality studies to identify the profiles of non-responders, mild responders, and good responders to optimize the drug's use for efficiency and safety in affected patients.