Upadacitinib for the Management of Alopecia Totalis and Subtotalis in Pediatric Patients: A Case Series

This case series evaluated the efficacy and safety of upadacitinib, a selective JAK1 inhibitor, in eight pediatric patients aged 9 to 14 years with alopecia totalis and subtotalis. All patients experienced clinical improvement, with most achieving complete or near-complete hair regrowth within a median of 3 months, and maintained results over a 14-month follow-up. Mild acne was the only side effect observed in two patients, with no serious adverse effects reported. The study concludes that upadacitinib shows promise as a treatment for refractory pediatric alopecia areata and is well-tolerated, but emphasizes the need for larger, controlled studies to confirm its efficacy and long-term safety. Limitations include the small sample size, lack of a control group, and potential biases due to retrospective data collection.