Janus Kinase Inhibition for the Treatment of Refractory Frontal Fibrosing Alopecia: A Case Series and Review of the Literature

This document presents a case series involving 3 patients with refractory frontal fibrosing alopecia (FFA) treated with Janus kinase (JAK) inhibitors, specifically topical ruxolitinib and oral baricitinib. The study highlights significant clinical improvements, including reduced pruritus, perifollicular erythema, and scale, with some evidence of hair regrowth. The cases suggest that JAK inhibitors, particularly topical ruxolitinib, may be a promising treatment for FFA, potentially due to their ability to penetrate the thinner skin of the frontal scalp more effectively. The findings support the role of JAK1/JAK2 in the pathogenesis and treatment of FFA, although further research is needed to fully understand the mechanisms involved.