Yao Longyan, He Jiumei, Lan Na, Lv Yongmei
The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
J Cosmet Dermatol. 2025 Jul;24(7):e70234. doi: 10.1111/jocd.70234.
Alopecia areata (AA) is an autoimmune disorder mediated by T cells, resulting in hair loss on the scalp, eyebrows, and body. Conventional treatments for AA often exhibit high recurrence rates and various side effects. Recently, Janus kinase (JAK) inhibitors have emerged as promising therapeutic options for managing AA and several other autoimmune disorders.
We present the case of a 26-year-old patient who initially responded well to Tofacitinib but subsequently experienced relapses during the treatment period. Corticosteroid therapy was effective in managing these relapses, leading to a transition to Ritlecitinib when Tofacitinib monotherapy became unsustainable.
In cases where monotherapy proves ineffective, alternative strategies such as combination therapy, dose optimization, or switching to different therapeutic agents should be considered. While the JAK-STAT signaling pathway plays a pivotal role in the pathogenesis of AA, it is likely that additional mechanisms also contribute to its development.
We present a case report documenting secondary failure of tofacitinib in the treatment of AA. This case highlights potential insights into the pathogenesis of AA and may inform the development of future therapeutic strategies.
斑秃（AA）是一种由T细胞介导的自身免疫性疾病，导致头皮、眉毛和身体毛发脱落。AA的传统治疗方法往往复发率高且有各种副作用。最近，Janus激酶（JAK）抑制剂已成为治疗AA和其他几种自身免疫性疾病的有前景的治疗选择。
我们报告一例26岁患者，该患者最初对托法替布反应良好，但随后在治疗期间复发。皮质类固醇疗法在控制这些复发方面有效，当托法替布单药治疗无法维持时，转而使用利特昔替尼。
在单药治疗无效的情况下，应考虑联合治疗、剂量优化或换用不同治疗药物等替代策略。虽然JAK-STAT信号通路在AA的发病机制中起关键作用，但可能还有其他机制也参与其发病过程。
我们报告一例托法替布治疗AA继发失败的病例报告。该病例突出了对AA发病机制的潜在见解，并可能为未来治疗策略的开发提供参考。
