Effectiveness of Oral Tofacitinib Dose Tapering in a Case of Alopecia Areata Universalis

Abstract

Introduction: Alopecia areata (AA) is a form of nonscarring alopecia and one of the most common autoimmune disorders. Persistent or severe variants lead to potential disfigurement and are associated with a significant negative impact on the patient's quality of life.

Case presentation: A 51-year-old female patient presenting with refractory alopecia universalis was successfully treated with oral tofacitinib. Recurrence was not observed following 17 months of therapy.

Discussion/conclusion: None of the currently employed therapies for AA are reliably effective nor are they approved for the disease. In this setting, Janus kinase inhibitors emerge as a promising novel treatment, as increasing evidence supports their effectiveness in AA.

Keywords: Alopecia areata; Hair disorder; Janus kinase inhibitor; Tofacitinib.

Fig. 1

Baseline photographs of our patient, showing a complete absence of eyebrows and scalp hair (SALT score 100). SALT, Severity of Alopecia Tool.

Fig. 2

At 6 weeks of treatment. Presence of fine vellus hair on the scalp and partial eyebrow regrowth can be noted.

Fig. 3

At 5 months of treatment. Significant hair regrowth can be seen on the scalp and eyebrows (SALT score 13). SALT, Severity of Alopecia Tool.

Fig. 4

At 8 months of treatment with tofacitinib 10 mg/daily. Complete hair regrowth can be observed (SALT score 4). SALT, Severity of Alopecia Tool.