小剂量巴瑞替尼成功治疗匐行性斑秃1例

Ophiasis Alopecia Areata Successfully Treated with Low-Dose Baricitinib:A Case Report

患者女,32岁,头部反复脱发斑15年伴加重4年。皮肤科情况:前额部发际线明显后移,头顶部毛发稀疏,颞侧及后枕部宽带状脱发斑,边缘锯齿状,拉发试验阳性,脱发严重度工具(SALT)评分48.6分,眉毛睫毛未见异常。毛发镜示:多发黄点征、黑点征及断发,散在锥形发及少量的直立新生发。诊断:匐行性斑秃。治疗:给予巴瑞替尼2 mg/d,治疗4周后脱发量减少,但新生发不明显,拉发试验转为阴性。治疗12周后复诊可见脱发斑明显减少,SALT评分9.2分。持续治疗48周,患者SALT降至0分。患者目前随访8个月仍未见复发。

A 32-year-old female presented with recurrent alopecia spots on the head for 15 years with aggravation for 4 years.Skin examination showed that the hairline on the forehead was significantly backward,the hair on the top of the head was sparse,the temporal and posterior occipital hair spots were wide band-like,the edge was serrated,the pull test was positive,the severity of alopecia tool(SALT)score was 48.6,and the eyebrows and eyelashes were normal.Trichoscopy showed multiple yellow dots,black dots,broken hair,scattered conical hair,and a small amount of erect new hairs.The diagnosis of ophiasis alopecia areata was made.Treatment:Baricitinib 2 mg/d was given.After 4 weeks of treatment,there was a reduction in hair loss,but not much new hair growth,and the hair pull test turned negative.After 12 weeks of treatment,the alopecia spots were significantly reduced,and the SALT score was 9.2.After continuous treatment for 48 weeks,the patient′s SALT dropped to 0.There was no evidence of recurrence during 8 months offollow-up.