Abrocitinib Improved Dupilumab-Resistant Severe Atopic Dermatitis with Comorbid Mild Alopecia Areata in a 12-Year-Old Boy: A Case Report with 1-Year Follow-Up

Figures & data

Figure 1 Clinical photographs at baseline. Extensive symmetrical red patches and papules with crusts and scales were observed on the patient’s (a) face, (c) trunk, and (d and e) extremities. (b) The occipital scalp showed a coin-sized patch of hair loss.

Figure 2 Clinical photographs after 12 weeks of abrocitinib treatment. (a, c-e) The skin manifestations improved significantly, and (b) hair regrowth occurred in the affected area of the scalp.

Table 1 Summary of Cases of AA in Pediatric Patients Treated with Systemic JAK Inhibitors in the Most Recent 2 Years

Report	Study Type	JAK Inhibitor	Dose	N	Age, y	Outcome	Adverse Events
Ma Y (2024)^Citation20	Case report	Tofacitinib	5 mg QD	1	6	Complete hair regrowth	None
Zhou J et al (2023)^Citation21	Retrospective cohort study	Tofacitinib	5 mg QD	5	3–14	Partial or complete hair regrowth (100%)	Excessive hair growth (n = 1)
Youssef S et al (2023)^Citation22	Case series	Tofacitinib	5 mg QD (n = 1), tapered up from 5 to 10 mg BID (n = 4), 10 mg BID (n = 5)	10	7–16	Complete hair regrowth (100%)	Mild facial acne (n = 1)
Huang J et al (2023)^Citation23	Case series	Tofacitinib	5 mg QD (n = 4), tapered up from 5 mg QD to BID (n = 2), 5 mg BID (n = 5)	11	7–12	Partial or complete hair regrowth (73%)	Mild increases in liver transaminase levels (n = 1), low haemoglobin (n = 1), folliculitis and elevated uric acid (n = 1)
Wagh N (2023)^Citation24	Case report	Tofacitinib	5 mg BID	1	14	Complete hair regrowth	None
Geng SL et al (2022)^Citation25	Case series	Tofacitinib	2.5 mg BID (n = 4), 2.5 mg + 5 mg (n = 1)	5	3–5	Significant or complete hair regrowth (100%)	Mild elevation of liver transaminase levels (n = 2)
Bhokare A (2022)^Citation26	Case report	Tofacitinib	Tapered up from 2.5 mg QD to BID	1	8	Complete hair regrowth	None
Moussa A et al (2023)^Citation27	Retrospective review	Baricitinib	Mean final dose 3.9 mg/d	29	12–17	Partial or complete hair regrowth (79%)	Mild: conjunctivitis (n = 1), neutropenia (n = 3), hypercholesterolaemia (n = 5), hypertriglyceridemia (n = 2), transaminitis (n = 3), and elevated serum creatinine (n = 4)
Zhan J et al (2023)^Citation28	Case series	Baricitinib	2 mg QD (n =3), 2 mg BID (n =2)	5	7–18	Significant hair regrowth (80%)	Mild infection (n = 1)
Asfour L et al (2023)^Citation29	Retrospective cohort study	Baricitinib	Mean dose 4 mg/d	19	8–12	Significant or complete hair regrowth (79%)	Mild acne (n= 2), self-limiting cold sore (n = 1), high cholesterol (n = 4), hypertriglyceridaemia (n = 1), mild neutropenia (n = 3)
Rotaru S et al (2023)^Citation30	Case report	Baricitinib	2 mg/d	1	8	Treatment was stopped due to severe tinea capitis	Severe tinea capitis
Kołcz K et al (2023)^Citation18	Case report	Upadacitinib	15 mg QD	1	14	Complete hair regrowth	Transient leukopenia
Yu D et al (2023)^Citation31	Case report	Upadacitinib	15 mg QD	1	9	Complete hair regrowth	None
Ha GU et al (2023)^Citation32	Case report	Upadacitinib	15 mg QD	1	15	Significant hair regrowth	None
Bourkas AN et al (2022)^Citation33	Case report	Upadacitinib	NA	1	14	Significant hair regrowth	NA
Zhao J et al (2022)^Citation34	Case report	Abrocitinib	200 mg QD	1	14	Complete hair regrowth	None
Huang J et al (2024)^Citation35	Case report	Abrocitinib	100 mg QD	1	11	Significant hair regrowth	None
Current case	Case report	Abrocitinib	200 mg QD	1	12	Complete hair regrowth	None

Abbreviations: M, male; F, female; AA, alopecia areata; N, number of pediatric patients; QD, once a day; BID, twice a day; NA, not available.

Table 2 Summary of Comorbid Cases of AD and AA in Pediatric Patients Treated with Selective JAK1 Inhibitors

Report	Age, y	Sex	Duration of AA (Months)	Previous Treatments	Reasons for changing Treatment	JAK Inhibitor	Duration of Treatment	Outcome	Adverse Events
Bourkas AN et al (2022)^Citation33	14	M	156	Intralesional corticosteroid injections, TCS, topical tacrolimus, oral cyclosporine, methotrexate, systemic minoxidil	New-onset hair loss with a dermatitis flare-up	Upadacitinib	5 months	Remission of AA and AD	NA
Kołcz K et al (2023)^Citation18	14	F	12	Topical minoxidil, TCS, topical diphencyprone, NB- UVB	No response	Upadacitinib	3 months	Remission of AA and AD	Transient leukopenia
Yu D et al (2023)^Citation31	9	F	84	TCS, topical minoxidil, tacrolimus and oral compound glycyrrhizin tablets, and glucocorticoids	No response	Upadacitinib	5 months	Remission of AA and AD	None
Zhao J et al (2022)^Citation34	14	F	36	TCS, oral antihistamines, Chinese acupuncture treatments	No response	Abrocitinib	Over 2 years	Remission of AA and AD	None
Current case	12	M	16	Oral Chinese herbal medicine, oral antihistamines, dupilumab	No response	Abrocitinib	Over 1 year (ongoing)	Remission of AA and AD	None

Abbreviations: M, male; F, female; AD, atopic dermatitis; AA, alopecia areata; TCS, topical glucocorticoids; NB-UVB, narrow-band ultraviolet B.

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