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Topical Jakafi successfully treats alopecia universalis

A patient in her late teens with alopecia universalis was successfully treated with topical Jakafi, with minimal adverse effects, according to study results recently published in JAMA Dermatology.

Brett A. King, MD, PhD, and colleagues studied the patient who presented with alopecia universalis. She had not received any treatment for 2 years and had previously been treated with prednisone, intralesional triamcinolone, sulfasalazine, topical squaric acid dibutylester and topical anthralin, which were ineffective. She had no scalp or arm hair and only sparse hair growth in the right lateral eyebrow.

Brett A. King

Because of apprehension of possible risks associated with oral Janus kinase (JAK) inhibitors, the patient and her parents decided to use Jakafi (ruxolitinib, Incyte), a topical JAK inhibitor. Baseline blood test results for HIV, hepatitis B and hepatitis C were negative. Complete blood cell count was within normal limits; however, the white blood cell (WBC) count was 4,500/µL, which was borderline low.

Topical ruxolitinib, 0.6% cream treatment was applied twice daily to the scalp and eyebrow regions. The patient had nearly normal eyebrows and growth of about 10% of scalp hair with “numerous 5-mm to 10-mm darkly pigmented hairs in arcuate and annular patches distributed over the entire scalp” after 12 weeks of treatment.

There were no adverse effects reported. A small, stable decrease in white blood cell count detected in laboratory monitoring at 4 weeks (3,800/µL), 8 weeks (4,100/µL) and 12 weeks (3,800/µL). No other abnormalities in complete blood cell count were found.

“This is the first report of successful treatment of alopecia universalis with topical JAK inhibitor,” the researchers concluded. “While additional studies will be needed to confirm the efficacy, further explore the safety and tolerability and determine optimal concentrations of topical ruxolitinib and other JAK inhibitors for alopecia areata and variants, the results of this case are promising. Topical JAK inhibitors represent an exciting new treatment opportunity for an often psychologically devastating condition.” – by Bruce Thiel

Disclosure: Craiglow reports no relevant financial disclosure Please see the full study for other researchers’ relevant financial disclosures.