Introduction Alopecia areata (AA) poses a significant therapeutic challenge. While biologics and Janus kinase (JAK) inhibitors offer novel treatment options, immunotherapy remains a relevant approach. This case series describes the long-term clinical experience and the practical use of contact immunotherapy in managing alopecia areata in combination with other current treatment modalities. Methods We present five patients with chronic alopecia areata who have been successfully treated with topical immunotherapy for 9–15 years in combination with other treatments, achieving excellent disease control and demonstrating long-term safety. Results All patients achieved sustained long-term disease control with a multimodal approach. Conclusion This case series highlights the enduring value of topical immunotherapy, even in the era of novel targeted therapies. It underscores the importance of individualized, multimodal approaches to optimize patient outcomes and demonstrates that traditional immunotherapy continues to be a valuable treatment option for alopecia areata.
Herz-Ruelas et al. (Tue,) studied this question.