Case Report: Vitiligo and Alopecia Universalis Following Rituximab Therapy in a Patient with Myasthenia Gravis

    Alzahrani D, Niaz G, Roblah TM, Al-Osaimi AK, Alsulaimani H
    TLDR Rituximab may cause skin issues, but baricitinib can help improve them.
    This case report describes a 30-year-old woman with myasthenia gravis who developed vitiligo and alopecia universalis during long-term treatment with rituximab, an anti-CD20 monoclonal antibody. The patient exhibited well-demarcated depigmented patches and diffuse non-scarring alopecia, consistent with a 100% Severity of Alopecia Tool (SALT) score. Rituximab was discontinued due to a possible drug reaction, and treatment with oral Baricitinib was initiated. Within 3 months, significant scalp hair regrowth and re-pigmentation of vitiligo patches were observed with minimal adverse effects. This case highlights the potential for immune-related skin adverse effects during rituximab therapy and suggests that early intervention with Janus kinase inhibitors like baricitinib may lead to favorable clinical outcomes.
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