Agarwal Priya, Ajuchi Oghenevoke, Lukowiak Tess M, Rao Babar K
Department of Dermatology, Rutgers Robert Wood Johnson Medical School, 1 Worlds Fair Drive, Somerset, NJ, 08873, USA.
Department of Dermatology, Weill Cornell Medicine, New York, NY, 10021, USA.
Arch Dermatol Res. 2025 Jun 9;317(1):803. doi: 10.1007/s00403-025-04301-z.
Scarring alopecias, including lichen planopilaris, frontal fibrosing alopecia, folliculitis decalvans, central centrifugal cicatricial alopecia, discoid lupus erythematosus, and dissecting cellulitis cause permanent destruction of hair follicles, resulting in patches of hair loss that can be devastating for patients. Treatment options for scarring alopecias focus on disease stabilization and currently include corticosteroids and immunosuppressive agents, which often offer inconsistent disease improvements with waning patient satisfaction, especially in severe stages of the condition. Recent advances in therapeutics such as biologics and JAK inhibitors may offer some potential for disease stabilization and resolution through modulation of the inflammatory and immune-mediated pathways of scarring alopecias. This review examines literature reporting the off-label use of biologics and JAK inhibitors for the treatment of scarring alopecias. We find that TNF-α, IL-17, and JAK inhibitors demonstrate the most potential of currently available agents, with IL-23 and Interferon Alpha Receptor 1 inhibitors also showing some benefit.
瘢痕性脱发，包括扁平苔藓性毛囊病、额部纤维性脱发、脱发性毛囊炎、中央离心性瘢痕性脱发、盘状红斑狼疮和穿掘性蜂窝织炎，会导致毛囊永久性破坏，从而引起脱发斑，这对患者来说可能是毁灭性的。瘢痕性脱发的治疗方案侧重于疾病稳定，目前包括皮质类固醇和免疫抑制剂，这些治疗方法往往只能带来不一致的病情改善，患者满意度也逐渐降低，尤其是在病情严重阶段。生物制剂和JAK抑制剂等治疗方法的最新进展可能通过调节瘢痕性脱发的炎症和免疫介导途径，为疾病稳定和治愈提供一些潜力。这篇综述研究了关于生物制剂和JAK抑制剂用于治疗瘢痕性脱发的非标签使用的文献。我们发现，TNF-α、IL-17和JAK抑制剂在目前可用的药物中显示出最大的潜力，IL-23和干扰素α受体1抑制剂也显示出一些益处。
