BH20 An unintended sequela of hair regrowth: severe Janus kinase inhibitor-associated acneiform eruption in alopecia areata

A 30-year-old woman with alopecia areata experienced significant hair regrowth after starting ritlecitinib, a Janus kinase inhibitor, but developed a severe acneiform eruption as a side effect. Despite initial improvement in her hair condition, with a SALT score reduction from 51 to 3, the acneiform eruption persisted, leading to the discontinuation of ritlecitinib. Subsequent treatments with oral prednisolone, trimethoprim, isotretinoin, and erythromycin were only partially effective, and the patient experienced a relapse of alopecia areata with a SALT score of 26. This case underscores the potential for JAK inhibitors to cause significant adverse effects, such as acneiform eruptions, which can limit their use despite successful hair regrowth. The patient's mental health was notably affected by the disease course.