А choice of therapy for severe forms of alopecia area

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Abstract

Alopecia areata is a chronic organ-specific autoimmune inflammatory disease with a genetic predisposition. Alopecia areata is characterized by damage to hair follicles, persistent or temporary non-scarring hair loss. A treatment of severe form of alopecia areata is a difficult task. Systemic glucocorticoids are indicated in the severe form of alopecia areata, which undoubtedly have side effects with a negative influence on health. The main idea of the article demonstrates clinical examples of the therapy for such patients, which based on the clinical experience. Modern medicine offers a new approach to the treatment of severe forms of alopecia areata, which bases on blocking Janus kinase (JAK). JAK converts and activates the transcription pathway in the pathogenesis of the disease. Currently, FDA (US Food and Drug Administration) has approved two Janus kinase inhibitors: baricitinib and ritlecitinib. Tofacitinib is a representative pan-JAK inhibitor that blocks JAK1/3 but inhibits JAK2 weakly. Tofacitinib hasn’t been approved for alopecia areata by FDA yet. The article demonstrates high effectiveness tofacitinibe of the therapy severe forms of alopecia areata: total and universal and also the safety of treatment.

About the authors

Yulia A. Gallyamova

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: 89161704546@mail.ru
ORCID iD: 0000-0002-1674-3007
SPIN-code: 5601-1201

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Patient 28 years old, diagnosis “severe alopecia areata”: a — before therapy; б — аfter 1.5 months of therapy; в — аfter 12 weeks of therapy; г — trichoscopy (broken hair, black dots, yellow dots, exclamation marks) аfter 12 weeks of therapy

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3. Fig. 2. Patient 35 years old, diagnosis “total alopecia”: а — before treatment; б — trichoscopy before treatment (yellow dots, black dots, absence of hair); в — after 9 months of therapy; г — trichoscopy after 9 months of therapy

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4. Fig. 3. Patient 52 years old, diagnosis “alopecia universalis”: а — before treatment; б — через 2 месяца терапии; в — after 3 months of therapy; г — after 4 months of therapy

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Copyright (c) 2025 Gallyamova Y.A.

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