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

This case report describes a 30-year-old woman with myasthenia gravis who developed vitiligo and alopecia universalis during long-term rituximab therapy. The patient exhibited well-demarcated depigmented patches and diffuse non-scarring alopecia, leading to a 100% Severity of Alopecia Tool (SALT) score. Rituximab was discontinued due to a suspected 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 result in favorable outcomes.