Case report: Dupilumab therapy for alopecia areata in a 4-year-old patient resistant to baricitinib

Lu Cai; Yi Wei; Min Zhao; Jia Zhuo; Xiao Tao; Mao Lin

doi:10.3389/fmed.2023.1253795

Case report: Dupilumab therapy for alopecia areata in a 4-year-old patient resistant to baricitinib

Front Med (Lausanne). 2023 Oct 9:10:1253795. doi: 10.3389/fmed.2023.1253795. eCollection 2023.

Authors

Lu Cai^{1

2}, Yi Wei¹, Min Zhao¹, Jia Zhuo¹, Xiao Tao¹, Mao Lin^{1

3}

Affiliations

¹ Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
² Chongqing Medical University, Chongqing, China.
³ Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Abstract

Alopecia areata (AA) is a non-scarring hair loss disorder. Alopecia totalis (AT) and alopecia universalis (AU) are the severe subtypes of AA. Age of onset before 6 years of age, disease duration of more than 1 year, and extensive alopecia involving more than 50% of the scalp (including AT or AU) suggest a poorer prognosis. Topical corticosteroids are the preferred first-line treatment for pediatric AA. While some treatments, such as intralesional corticosteroids, systemic steroids, contact immunotherapy with squaric acid dibutyl ester, and JAK inhibitors, showed efficacy in adults with AA, their safety profiles limit their use in pediatric AA patients. Dupilumab is a biologic that effectively addresses the patho-physiology of Th2 allergic diseases, and treats atopic diseases by inhibiting the helper Th2 immune axis. AA has been reported to be significantly improved with dupilumab for atopic dermatitis (AD) in children and adults. We report hair regrowth over all of the scalp, eyebrows, and eyelashes after 10 months of dupilumab therapy in a 4-year-old AU patient resistant to baricitinib.

Keywords: Th1; Th2; alopecia areata; dupilumab; pediatric patients; resistant to baricitinib.

Publication types

Case Reports

Grants and funding

This study was funded by “Youth Qi Huang Scholar” project by State Administration of TCM, National Natural Science Foundation of China (81402601) and Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (2022DBXM007).