Tofacitinib Citrate for the Treatment of Nail Dystrophy Associated with Alopecia Universalis

The document reports on the use of tofacitinib citrate, a Janus kinase (JAK) inhibitor, for treating nail dystrophy in three patients with alopecia universalis (AU). The patients, two men in their 20s and one woman in her 40s, were treated with tofacitinib at doses of 5 mg twice daily, with one patient increasing to 10 mg in the morning and 5 mg at night after two months. Over a period of 5 to 6 months, all three patients experienced remission of nail changes and associated discomfort or pain. Two of the patients also experienced hair growth, although one did not. The treatment was well tolerated, with no observed side effects such as infections, cytopenias, transaminitis, decreased renal function, or increased lipid levels. The study suggests that tofacitinib and other JAK inhibitors may be effective in treating severe nail dystrophy associated with AA and its variants, but additional studies are needed to confirm efficacy and safety.