Complete Regrowth of Beard Hair with Ruxolitinib in an Alopecia Universalis Patient

Abstract

While most alopecia areata (AA) cases resolve spontaneously, the more severe types of AA, alopecia totalis (AT) and alopecia universalis (AU), can be highly resistant to therapy. We report on a 33-year-old ultraorthodox Jewish man with an 11-year history of AA that resulted in complete loss of the scalp and body hair 7 years ago. Previous treatments with intralesional and systemic corticosteroids had only partial and temporary effects. The patient was treated with ruxolitinib, 20 mg twice daily, resulting in complete growth of the beard after 4 months of treatment. The beard has a special significance for ultraorthodox Jews, and loss of the beard hair can have marked social and psychological consequences in AA patients. The Janus kinase (JAK) inhibitors have recently emerged as an effective treatment modality in AA, including the more severe forms, such as AT or AU. This report highlights the beneficial effects of the JAK inhibitors, especially in populations where the hair has a special importance due to cultural and religious backgrounds.

Incipient Diabetes Mellitus and Nascent Thyroid Disease Presenting as Beard Alopecia Areata: Case Report and Treatment Review of Alopecia Areata of the Beard

“…Other associated conditions with alopecia areata include atopic dermatitis, celiac disease, pernicious anemia, psoriasis, rheumatoid arthritis, systemic lupus erythematosus, and vitiligo [3,4]. Multiple therapies have been identified as effective treatments for beard alopecia areata ( Table 1) [3][4][5][6][7][8][9][10][11][12][13][14]. Treatment with corticosteroids (either intralesional or topical) is usually the first line of therapy.…”

“…Immunosuppressants [5,7], CR Corticosteroids (intralesional injections, topical) [5,7], CR Immunotherapy [6] Anthralin and diphenylcyclopropenone [6] Janus kinase (JAK) inhibitors [3,8,9] Ruxolitinib [8] Tofacitinib [3,9] Laser [10][11][12] 308-nm excimer laser [10] 908-nm diode laser [11] 1,550-nm fractional laser [12] Minoxidil [7] Photodynamic therapy [13] Platelet-rich plasma (PRP) [14] Prostaglandin F2-alpha analogues [7] Latanoprost [7] Treatment of concurrent Helicobacter pylori infection [4] Our patient decided to treat his beard alopecia areata with topical 0.1% triamcinolone acetonide cream. This led to a complete regrowth of his beard hair within six months.…”

“…JAK inhibitors have been used to treat skin conditions such as psoriasis and vitiligo. Ruxolitinib and tofacitinib are JAK inhibitors that have been efficacious at specifically treating alopecia areata of the beard [3,8,9].…”

Role of janus kinase inhibitors in the treatment of alopecia areata

“…A number of case reports and one open-label, single-arm trial of ruxolitinib have been published ( Table 2 ). 10 , 50 , 68 – 73 Concerning oral ruxolitinib, Xing et al, apart from establishing the effects of JAKis in alopecic skin through in vivo study, had reported three cases of AA treated with 20 mg of oral ruxolitinib twice daily. 10 All three patients experienced near-complete regrowth within 3–5 months.…”

Evaluation of Serum Paraoxonase, Arylesterase, Prolidase Activities and Oxidative Stress in Patients with Alopecia Areata

“…The development of the disease displays different courses to a great extent for patients, and the most prevalent for AA is the patchy type defined by oval areas of hair loss which is usually followed by spontaneous recovery. Alopecia totalis, one of the severe types of AA, causes complete loss of scalp hair while alopecia universalis leads to complete loss of scalp and body hair [5]. The chance of full recovery for alopecia totalis or universalis is lower than 10% [6].…”