Refractory alopecia in lupus treated with tofacitinib - a case-based review

Clin Rheumatol. 2023 Aug;42(8):2237-2241. doi: 10.1007/s10067-023-06632-6. Epub 2023 May 15.

Abstract

One of the common cutaneous symptoms of systemic lupus erythematosus (SLE) that may have major psychosocial effects in a female is diffuse alopecia. Although Janus kinase inhibitors have shown encouraging results in the treatment of SLE and of alopecia areata in recent studies, tofacitinib in treating refractory alopecia caused by SLE has been rarely documented. The Janus kinases (JAKs) are intracellular tyrosine kinases that play a significant role in the pathophysiology of SLE by participating in a wide range of inflammatory cascades. Here, we reported a 33-year-old SLE patient with long standing (3 years) refractory alopecia who took tofacitinib and observed a substantial increase in hair growth. This was sustained at 2-years follow-up even after tapering off glucocorticoids completely. In addition, we reviewed the literature to look for further evidence to support the use of JAK inhibitors for alopecia in SLE.

Keywords: Diffuse non-scarring alopecia; Hair regrowth; Janus kinase inhibitor; Systemic lupus erythematosus; Tofacitinib.

Publication types

  • Review

MeSH terms

  • Adult
  • Alopecia / drug therapy
  • Alopecia Areata* / drug therapy
  • Female
  • Humans
  • Janus Kinase Inhibitors* / therapeutic use
  • Janus Kinases
  • Lupus Erythematosus, Systemic* / complications
  • Lupus Erythematosus, Systemic* / drug therapy

Substances

  • tofacitinib
  • Janus Kinase Inhibitors
  • Janus Kinases

Supplementary concepts

  • Diffuse alopecia