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Recalcitrant alopecia areata responsive to leflunomide and anthralin—Potentially undiscovered JAK / STAT inhibitors?
Author(s) -
Sardana Kabir,
Gupta Aastha,
Gautam Ram K.
Publication year - 2018
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13688
Subject(s) - medicine , alopecia areata , leflunomide , stat , pathogenesis , immunology , pharmacology , dermatology , signal transduction , rheumatoid arthritis , stat3 , biology , biochemistry
Abstract Several treatment modalities are available for the management of alopecia areata ( AA ); however, no therapy is universally effective and treatment can be frustrating in severe cases, with low response and high recurrence rates. Recent studies show that the JAK / STAT pathway plays a central role in the pathogenesis of this disease by determining the crosstalk between the infiltrating CD 8+ T cells and the hair follicles, suggesting a role of JAK inhibitors in the treatment of AA . However, reports on the off‐label use of these more expensive targeted agents have shown variable results. We present a case of a child with recalcitrant ophiasis‐pattern AA who had failed steroid therapy and was treated successfully with leflunomide and anthralin, possibly by the synergistic effect on the JAK / STAT pathway inhibition, and we propose this combination could be a cost‐effective therapeutic option for recalcitrant AA.