Potential Treatment of Steroid-Resistant Alopecia Areata Using Allogeneic Exosomes Derived From Adipose Tissue Mesenchymal Stromal Cells: A Case Report

A 31-year-old man with severe, corticosteroid-resistant alopecia areata experienced significant hair regrowth after treatment with allogeneic exosomes derived from adipose tissue mesenchymal stromal cells (ADMSCs-Exo). Over 12 weeks, he received four sessions of treatment, resulting in near-complete hair restoration and cessation of hair shedding. The treatment increased anti-inflammatory cytokines and reduced pro-inflammatory cytokines to baseline levels, with no adverse effects reported during the treatment or the 18-week follow-up. Although this case involves only one patient, it indicates that ADMSC-derived exosomes could be a promising cell-free therapeutic option for refractory alopecia areata.