Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis

In a 2014 case study, a 25-year-old male with alopecia universalis and plaque psoriasis experienced significant hair regrowth after treatment with oral tofacitinib, a JAK 1/3 inhibitor. Initially unresponsive to other treatments, the patient began to see partial hair regrowth after two months on a daily dose of 5 mg tofacitinib twice daily. The dosage was increased to 10 mg in the morning and 5 mg at night, resulting in complete scalp hair regrowth and significant regrowth of eyebrows, eyelashes, and other body hair after an additional three months. After eight months, full hair regrowth was observed in all areas except the arms and legs. The patient's psoriasis also improved, and he reported no side effects or laboratory abnormalities. This case marked the first report of a pathogenesis-based therapy for alopecia universalis, indicating that tofacitinib and other JAK inhibitors may be effective treatments for alopecia areata and its variants, although clinical trials were recommended for a more systematic evaluation.