Oral Tofacitinib in Refractory Pediatric Alopecia Areata

Alopecia areata (AA) is an autoimmune condition resulting in nonscarring hair loss. Treatment in pediatric patients remains challenging, with limited effective therapeutic options. Janus kinase inhibitors, including tofacitinib, have emerged as promising agents for refractory cases. This case series evaluates the efficacy and safety of oral tofacitinib in pediatric patients with patchy AA. Seven pediatric patients (four boys and three girls; age range: 2–16 years) with patchy AA unresponsive to conventional therapies were treated with oral tofacitinib for 1 month. Patient characteristics, baseline Severity of Alopecia Tool (SALT) scores, treatment regimen, and outcomes were documented. The mean SALT score at baseline was 12.71. After 1 month of oral tofacitinib therapy, six patients demonstrated significant hair regrowth ranging from 50% to 90%, while one patient showed no improvement. No adverse effects were observed during the treatment period. Oral tofacitinib may be an effective and safe therapeutic option for pediatric AA refractory to standard treatments. Most patients responded well, but larger studies are needed to assess long-term safety and identify efficacy biomarkers.