![]() In our patient, being an ultraorthodox Jewish man, the loss of the beard hair had a significant effect on the social life of the patient, urging us to try newer treatment options. High-quality randomized-controlled trials with large sample sizes are lacking. Although AA of the beard is a common entity in clinical practice, it is interesting to note that its psychological and social effects have not been specifically studied. The most promising therapies with the highest quality data include diphenylcyclopropenone, squaric acid dibutylester, photodynamic therapy, steroids, and cyclosporine in combination with methylprednisolone. 2,3 The preferred treatments for AA include therapeutic. 1 The deterioration in the quality of life caused by the disease and the temporal and financial burden of treatment are the major issues among patients with AA. Loss of beard hair can have a more significant impact in some populations, as unshaved beard is important in expressing specific religious norms, such as in some Islamic societies and for orthodox and ultraorthodox Jews. Alopecia areata (AA) is a chronic and relapsing hair folliclespecific autoimmune disease that leads to nonscarring hair loss. Trachyonychia can be associated with alopecia universalis although the treatment strategies of both conditions differ. While it is usually believed that the extent of hair loss is the best predictor of the severity of distress the patients will experience, for some populations, it is more a question of location than extent of hair loss determining the psychological effects. Abstract A 43-year-old man presented with long-standing trachyonychia of all 20 nails, noted worsening of his nail disease after the onset of alopecia universalis 18 months ago prior to presentation. A higher prevalence of depression, anxiety, poor self-esteem and body image, social phobias, and paranoid disorders have been reported, resulting in a reduced quality of life. This report highlights the beneficial effects of the JAK inhibitors, especially in populations where the hair has a special importance due to cultural and religious backgrounds.Īlopecia areata can lead to significant psychological and social sequelae in many patients. The Janus kinase (JAK) inhibitors have recently emerged as an effective treatment modality in AA, including the more severe forms, such as AT or AU. The beard has a special significance for ultraorthodox Jews, and loss of the beard hair can have marked social and psychological consequences in AA patients. ![]() The patient was treated with ruxolitinib, 20 mg twice daily, resulting in complete growth of the beard after 4 months of treatment. Previous treatments with intralesional and systemic corticosteroids had only partial and temporary effects. We report on a 33-year-old ultraorthodox Jewish man with an 11-year history of AA that resulted in complete loss of the scalp and body hair 7 years ago. 3 Tofacitinib resulted in SALT50 in 32.2 of cases. 2 The appeal of topical JAKi is potentially a reduced side effect profile through a different mode of entry. ![]() While most alopecia areata (AA) cases resolve spontaneously, the more severe types of AA, alopecia totalis (AT) and alopecia universalis (AU), can be highly resistant to therapy. While the use of oral JAKi has shown potential as a successful treatment for AA, oral JAKi have been associated with side effects, such as infections, viral reactivation and rarely thromboembolic events.
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