The Use of Janus Kinase Inhibitors for Primary Neutrophilic Cicatricial Alopecias

This study reviews the use of Janus kinase inhibitors (JAKis) for treating primary neutrophilic cicatricial alopecias (PNCAs), specifically folliculitis decalvans (FD) and dissecting cellulitis of the scalp (DCS), which are often resistant to standard treatments. The review included five studies with a total of 10 patients, 7 with FD and 3 with DCS, all of whom had refractory cases. Patients treated with JAKis, such as baricitinib, tofacitinib, upadacitinib, and abrocitinib, achieved remission within 1-4 months, with some sustaining remission for up to 16 months. Adverse effects were noted in FD cases but not in DCS cases. The study suggests that JAKis could be a promising treatment for refractory PNCAs, although larger studies are needed to confirm efficacy.