Trichoscopic Markers and Clinical Response Patterns With Ritlecitinib in Severe Alopecia Areata: 24-Week Outcomes From a Prospective Real-World Cohort

January 2026 in “ Dermatologic Therapy ”

N Perrotta, Luigi Angelo Fiorito, Roberta Vescovo, Antonio Ricupito, Giuseppe Paolo Antonio Gemma, Elisabetta Angela Campanale, Marco Virone, Riccardo Sadun, Giulio Bortone, Alfredo Rossi, Annunziata Dattola, Steven Paul Nisticò, Giovanni Pellacani, Lorenzo Ala

ritlecitinib alopecia areata Severity of Alopecia Tool SALT score trichoscopic evaluations hair regrowth

Studysummary In this prospective study, ritlecitinib effectively reduced hair loss in patients with severe alopecia areata, with 43.3% of participants achieving a 20 or lower SALT score by week 24, and showed a good midterm safety profile.

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This study evaluated the effectiveness and safety of ritlecitinib in 30 adults with severe alopecia areata over 24 weeks. The mean Severity of Alopecia Tool (SALT) score decreased significantly from 79.7 to 44.5, with 43.3% of patients achieving a SALT score of ≤ 20. Trichoscopic evaluations indicated early and progressive hair regrowth, and patient-reported outcomes showed improvements in anxiety and depression scores. No serious adverse events were reported, and laboratory parameters remained stable. The study concludes that ritlecitinib is effective and safe for treating severe alopecia areata, with detailed response patterns observed through various assessment methods.

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research The Hidden Burden of Visibility: Social Appearance Anxiety in Patients With Alopecia Areata – A Comparative Cross-Sectional Study

1 citations , November 2025 in “Journal of Health Psychology”

This study found that individuals with Alopecia Areata experience significantly higher social appearance anxiety compared to healthy controls, driven more by appearance-related concerns than by general anxiety or depression, highlighting the importance of targeted psychosocial assessments in their routine care.

research Real-World Ritlecitinib Treatment of Severe Alopecia Areata in the US: Patient Characteristics and Physician Satisfaction

July 2025 in “SKIN The Journal of Cutaneous Medicine”

This study describes characteristics and outcomes for adults initiating ritlecitinib for severe alopecia areata, highlighting increased hair regrowth and physician satisfaction with longer treatment durations, despite ongoing psychosocial impacts like embarrassment and anxiety among patients.

research Long-Term Safety and Efficacy of Ritlecitinib in Adults and Adolescents with Alopecia Areata and at Least 25% Scalp Hair Loss: Results from the ALLEGRO-LT Phase 3, Open-Label Study

15 citations , January 2025 in “Journal of the European Academy of Dermatology and Venereology”

Ritlecitinib is effective and safe for treating alopecia areata, promoting significant hair regrowth.

research Efficacy and Safety of the Oral Janus Kinase 3/Tyrosine Kinase Inhibitor Ritlecitinib Over 24 Months: Integrated Analysis of the ALLEGRO Phase IIb/III and Long-Term Phase III Clinical Studies in Alopecia Areata

23 citations , October 2024 in “British Journal of Dermatology”

In this study, ritlecitinib showed sustained effectiveness and a favorable safety profile in treating alopecia areata in patients aged 12 and older over 24 months, with improvements observed in hair and eyebrow regrowth and patient satisfaction.

Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program

research Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program

January 2024 in “American journal of clinical dermatology”

This study reports that ritlecitinib, when used for up to 24 months in patients aged 12 and older with alopecia areata, has an acceptable safety profile, with a similar proportion of adverse events in both ritlecitinib and placebo groups in the placebo-controlled cohort.

research Trichoscopy Patterns in Alopecia Areata: A Systematic Review and Meta-Analysis

2 citations , June 2023 in “Skin Research and Technology”

This study reviewed 39 studies with 3204 patients to identify characteristic trichoscopic findings in alopecia areata, highlighting yellow and black dots, broken, short vellus, and tapering hairs as key indicators. It found no single diagnostic trichoscopic finding but observed trichoscopy's utility in monitoring treatment response.

research Efficacy and Safety of Ritlecitinib in Adults and Adolescents With Alopecia Areata: A Randomised, Double-Blind, Multicentre, Phase 2b–3 Trial

227 citations , April 2023 in “The Lancet”

Ritlecitinib effectively treats alopecia areata and is well-tolerated.

research Trichoscopy in Alopecia Areata

7 citations , November 2022 in “Actas Dermo-Sifiliográficas”

This study reviewed the usefulness of trichoscopy in diagnosing and monitoring alopecia areata, noting that the technique identifies specific hair features like yellow and black dots, which are linked to the disease's chronic nature and treatment response.

research Patient Perspectives of the Social, Emotional and Functional Impact of Alopecia Areata: A Systematic Literature Review

67 citations , March 2021 in “Dermatology and Therapy”

This review discusses the substantial impact of alopecia areata on patients' health-related quality of life, highlighting issues such as personality changes, emotional and social difficulties, and a common occurrence of alexithymia, and emphasizes the need for more specific assessment tools.

research Trichoscopy of Alopecia Areata: An Update

89 citations , March 2018 in “The Journal of Dermatology”

This review presents various trichoscopic findings for diagnosing alopecia areata but reports no new clinical results, emphasizing that no single marker is pathognomonic and multiple features should be considered together.

research SALT II: A New Take on the Severity of Alopecia Tool for Determining Percentage Scalp Hair Loss

44 citations , November 2016 in “Journal of The American Academy of Dermatology”

This article updates a diagnostic tool (SALT II) for assessing hair loss by adding more precise measurements of scalp surface area, particularly useful for various types of alopecia.

research Alopecia Areata and Health-Related Quality of Life: A Systematic Review and Meta-Analysis

128 citations , February 2016 in “British Journal of Dermatology”

This study found that patients with alopecia areata experience significant impairments in health-related quality of life, notably affecting mental health, according to various quality of life assessment tools.

research The Autoimmune Basis of Alopecia Areata: A Comprehensive Review

162 citations , October 2014 in “Autoimmunity reviews”

This review discusses alopecia areata, highlighting its autoimmune aspects, environmental triggers, and current treatment options, but reports no new clinical results; recent studies suggest JAK pathway intervention may offer therapeutic potential.

research Trichoscopic Findings in Alopecia Areata and Their Relation to Disease Activity, Severity, and Clinical Subtype in Turkish Patients

26 citations , August 2013 in “Australasian Journal of Dermatology”

This study found that certain trichoscopic patterns, like exclamation mark hairs, were associated with active or mild alopecia areata in Turkish patients, aiding in diagnosis and prediction of the disease.

research Trichoscopy Update 2011

178 citations , December 2011 in “Journal of Dermatological Case Reports”

This review discusses the application of trichoscopy in diagnosing various hair and scalp diseases and reports no new clinical results; the authors emphasize its role as a non-invasive diagnostic tool.