A 26-year-old man loses more than 80 percent of his scalp hair over 18 months (SALT score above 50) with eyebrow and beard involvement. Topical steroids and intralesional triamcinolone have failed. Which systemic agent has regulatory approval for severe alopecia areata?
- A Baricitinib ✓
- B Secukinumab
- C Dupilumab
- D Apremilast
Correct answer: A. Baricitinib
Explanation
Baricitinib, an oral JAK1 and JAK2 inhibitor, is the agent approved for severe alopecia areata in adults, restoring substantial scalp coverage in many patients with SALT scores above 50. Dupilumab blocks IL-4 and IL-13 signalling and is used in atopic dermatitis, secukinumab targets IL-17C for psoriasis, and apremilast inhibits phosphodiesterase-4 for psoriasis and psoriatic arthritis. None of these three has efficacy data supporting use in extensive alopecia areata.
Reference: Rook's Textbook of Dermatology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.