Concomitant Management of Alopecia Universalis and Ulcerative Colitis With Upadacitinib

This case study discusses the management of a 32-year-old female patient with concurrent alopecia universalis (AU) and ulcerative colitis (UC) using upadacitinib, a selective JAK-1 inhibitor. The patient, with a history of multiple autoimmune diseases, experienced complete body hair loss after changes in her UC medication regimen. Despite stopping mercaptopurine, hair loss continued, leading to a diagnosis of AU. Upadacitinib was initiated after discontinuing infliximab due to safety concerns with dual JAK inhibitor use. Remarkably, significant hair regrowth was observed after 4 months of upadacitinib treatment, while maintaining UC remission. This suggests that upadacitinib may be a promising treatment for patients with both UC and AA, leveraging the JAK–STAT pathway involved in both conditions.