Kakeji Yukito, Kogame Toshiaki, Yagi Yosuke, Kambe Naotomo, Kabashima Kenji
Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan.
Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Skin Health Dis. 2025 Apr 7;5(2):154-157. doi: 10.1093/skinhd/vzaf013. eCollection 2025 Apr.
Alopecia areata (AA) is an autoimmune disease that causes recurrent hair loss. No treatment has been effective in the long term because of the unstable efficacy and possible side effects. AA is primarily driven by Th1-type inflammation, centred around CD8 T cells and interferon-γ (IFN-γ). Recent studies have revealed that the Janus kinase (JAK) family is also involved in the pathogenesis of AA, leading to JAK inhibitors emerging as a treatment for AA. We present a case of a 39-year-old Japanese woman with severe AA who exhibited a Severity of Alopecia Tool (SALT) score 80 accompanied by atopic dermatitis (AD). Despite conventional treatments, the condition worsened from a SALT score of 80 to 100. We subsequently attempted treatment with an excimer laser (EL), but no hair regrowth was observed. However, the introduction of 0.5% delgocitinib ointment in combination with EL led to complete hair regrowth beginning 2 months later, with complete remission achieved after 1 year. This case highlights the potential efficacy of combining delgocitinib ointment with EL in treating severe AA, particularly in patients with AD. The findings suggest that this combination therapy may provide a safer and more effective alternative to oral JAK inhibitors. Nevertheless, further studies are needed to elucidate the underlying mechanisms and fully evaluate the therapeutic synergy.
斑秃（AA）是一种导致复发性脱发的自身免疫性疾病。由于疗效不稳定和可能的副作用，长期以来没有一种治疗方法是有效的。AA主要由以CD8 T细胞和干扰素-γ（IFN-γ）为中心的Th1型炎症驱动。最近的研究表明，Janus激酶（JAK）家族也参与了AA的发病机制，从而使JAK抑制剂成为AA的一种治疗方法。我们报告了一例39岁患有严重AA的日本女性病例，其脱发严重程度工具（SALT）评分为80，并伴有特应性皮炎（AD）。尽管采用了传统治疗方法，病情仍从SALT评分80恶化至100。随后我们尝试用准分子激光（EL）进行治疗，但未观察到毛发再生。然而，联合使用0.5%的地高替尼软膏与EL治疗后，2个月后开始出现完全毛发再生，1年后实现完全缓解。该病例突出了地高替尼软膏与EL联合治疗严重AA的潜在疗效，尤其是对患有AD的患者。研究结果表明，这种联合治疗可能为口服JAK抑制剂提供一种更安全、更有效的替代方案。尽管如此，仍需要进一步研究以阐明其潜在机制并充分评估治疗协同作用。
