Approach to Managing Recalcitrant Alopecia Areata with Combination Therapy: A Series of Five Cases in Black Pediatric Patients

This case series investigates the treatment of moderate to severe alopecia areata in five Black pediatric patients using a combination of topical JAK inhibitors, oral fexofenadine, and vitamin D supplementation, with additional therapies like oral upadacitinib and phototherapy in some cases. All patients showed significant hair regrowth and reduced disease severity, with minimal adverse effects. The study supports the efficacy of JAK inhibitors and combination therapy in managing pediatric alopecia areata, particularly in patients of color, and underscores the importance of maintenance therapy to prevent relapse. Further research is needed to better understand alopecia areata in this demographic.