Baricitinib for Alopecia Universalis Following Drug-Induced Hypersensitivity Syndrome/Drug Reaction with Eosinophilia and Systemic Symptoms

A 50-year-old woman developed alopecia universalis (AU) following drug-induced hypersensitivity syndrome (DIHS)/drug reaction with eosinophilia and systemic symptoms (DRESS) after taking sodium valproate. Initial treatments, including corticosteroids and cyclosporine, were ineffective. However, baricitinib, a Janus kinase (JAK) 1/2 inhibitor, led to significant hair regrowth, with 90% of scalp hair regrown by week 48 without adverse effects. This case highlights the potential of JAK inhibitors like baricitinib in treating AU associated with DIHS/DRESS, likely due to their ability to modulate cytokine signaling pathways involved in both conditions.