Effectiveness of Baricitinib on Nail Alopecia Areata: A 48-Week Single-Center Retrospective Study

This study evaluated the effectiveness of baricitinib, a Janus kinase 1/2 inhibitor, in treating nail manifestations in 37 patients with severe alopecia areata (AA) over 48 weeks. Patients received 4 mg/day of baricitinib, resulting in significant improvements in hair regrowth and nail abnormalities. The mean SALT score decreased from 100 to 16.3, and the average number of affected nails reduced from 6.4 to 2.1. Clinician Reported Outcome scores also showed significant improvement. Despite these positive results, the correlation between hair and nail improvement was weak, indicating different responsiveness. The study concludes that baricitinib is a promising treatment for nail involvement in AA, but acknowledges limitations such as the small sample size and lack of long-term data.