Therapeutic Synergy Between Contact Dermatitis from a Wig-Fixing Device and Tofacitinib on Alopecia Areata

In 2018, a case study reported a 29-year-old man with a 1-year history of extensive alopecia areata (AA) experiencing hair regrowth after treatment with tofacitinib, an oral medication, in conjunction with contact dermatitis from a wig-fixing device. The patient had previously been unsuccessfully treated with systemic corticosteroids and cyclosporin. After starting tofacitinib at a dose of 5 mg twice daily, hair growth began within a month, specifically in the area affected by contact dermatitis, and complete hair regrowth was observed after 5 months. The authors suggested that there might be a synergistic effect between the contact dermatitis and tofacitinib, as hair regrowth initiated from the area of contact dermatitis after tofacitinib administration. They hypothesized that tofacitinib's downregulation of pro-inflammatory mediators might act synergistically with the resolution of contact dermatitis to inhibit the autoimmune reaction responsible for AA. This case was the first to suggest a synergistic effect between contact dermatitis and tofacitinib in treating AA, indicating a need for further research to understand the mechanisms and potential of this combination therapy.