The Development of Oral Hairy Leukoplakia During JAK Inhibitor Baricitinib Therapy

    September 2023 in “ JAAD case reports ”
    Fahad Ahmed, Syed Minhaj Rahman, Sarah Trent, Adel Haque
    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 In this review, the authors noted that while baricitinib, a treatment for refractory rheumatoid arthritis and severe alopecia areata, shows promising efficacy, it may pose risks of serious infections and malignancy due to immune downregulation. Our plain-language summary of this paper — not a Tressless recommendation.
    The document presents a case of a 50-year-old man with alopecia universalis (AU) who developed oral hairy leukoplakia (OHL) while on baricitinib therapy. Baricitinib is a JAK1/JAK2 inhibitor used for treating refractory rheumatoid arthritis and severe alopecia areata (AA). The patient, who had a 25-year history of AU, started on baricitinib therapy in July 2022. By March 2023, he showed patchy hair regrowth on his scalp, arms, axilla, and eyebrows. However, he was also diagnosed with OHL during a routine dental visit in the same month. The document suggests that all JAK inhibitors, including baricitinib, pose the risk of immune-related adverse events due to their downregulation of cytokines and growth factors involved in the adaptive immune response. The document concludes that clinicians should be aware of this potential adverse event during JAK inhibitor therapy for timely and appropriate patient management.
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