Tumor Necrosis Factor Inhibitors and Janus Kinase Inhibitors in the Treatment of Cicatricial Alopecia: A Systematic Review

Recent studies suggest that Janus kinase (JAK) inhibitors, particularly oral tofacitinib, and tumor necrosis factor (TNF) inhibitors, especially adalimumab, show promise as treatments for cicatricial alopecia (CA). Tofacitinib and adalimumab were effective in improving CA symptoms with minimal adverse effects (AEs). Other JAK inhibitors like baricitinib and TNF inhibitors such as infliximab also showed positive results but with varying degrees of AEs. However, some TNF inhibitors, including thalidomide and lenalidomide, caused significant AEs, and paradoxical CA was observed in some cases. Regular monitoring of AEs is recommended, and further research is needed for definitive treatment guidelines.