A Case of Alopecia Totalis with Lichen Planus Hypertrophicus Responded Excellently to Oral Tofacitinib: An Observation

A 23-year-old female with alopecia totalis and lichen planus hypertrophicus showed significant improvement after treatment with oral tofacitinib, a JAK 1/3 inhibitor. Initially treated with cyclosporine without success, the patient began tofacitinib at 5 mg twice daily, leading to hair regrowth and improvement of skin lesions within 2-2.5 months, with notable progress at 9 months. Tofacitinib was well tolerated, with no serious adverse effects, and was followed by methotrexate for maintenance. This case suggests tofacitinib as a promising treatment for severe, treatment-resistant cases of alopecia areata and lichen planus hypertrophicus.