{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:30:10Z","timestamp":1768350610773,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T00:00:00Z","timestamp":1539561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"Abstract<\/jats:title>Several treatment modalities are available for the management of alopecia areata (AA<\/jats:styled-content>); however, no therapy is universally effective and treatment can be frustrating in severe cases, with low response and high recurrence rates. Recent studies show that the JAK<\/jats:styled-content>\/STAT<\/jats:styled-content> pathway plays a central role in the pathogenesis of this disease by determining the crosstalk between the infiltrating CD<\/jats:styled-content>8+ T cells and the hair follicles, suggesting a role of JAK<\/jats:styled-content> inhibitors in the treatment of AA<\/jats:styled-content>. However, reports on the off\u2010label use of these more expensive targeted agents have shown variable results. We present a case of a child with recalcitrant ophiasis\u2010pattern AA who had failed steroid therapy and was treated successfully with leflunomide and anthralin, possibly by the synergistic effect on the JAK<\/jats:styled-content>\/STAT<\/jats:styled-content> pathway inhibition, and we propose this combination could be a cost\u2010effective therapeutic option for recalcitrant AA.<\/jats:p>","DOI":"10.1111\/pde.13688","type":"journal-article","created":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T07:18:11Z","timestamp":1539587891000},"page":"856-858","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Recalcitrant alopecia areata responsive to leflunomide and anthralin\u2014Potentially undiscovered JAK<\/scp>\/STAT<\/scp> inhibitors?"],"prefix":"10.1111","volume":"35","author":[{"given":"Kabir","family":"Sardana","sequence":"first","affiliation":[{"name":"Dr Ram Manohar Lohia Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4057-5365","authenticated-orcid":false,"given":"Aastha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Dr Ram Manohar Lohia Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram K.","family":"Gautam","sequence":"additional","affiliation":[{"name":"Dr Ram Manohar Lohia Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,15]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.12264"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3645"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13598"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000445182"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.096743"},{"key":"e_1_2_4_7_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4049\/jimmunol.159.1.22","article-title":"The immunosuppressive metabolite of leflunomide, A77 1726, affects murine T cells through two biochemical mechanisms","volume":"159","author":"Elder RT","year":"1997","journal-title":"J Immunol"},{"key":"e_1_2_4_8_1","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.4049\/jimmunol.160.4.1581","article-title":"Inhibition of JAK3 and STAT6 tyrosine phosphorylation by the immunosuppressive drug leflunomide leads to a block in IgG1 production","volume":"160","author":"Siemasko K","year":"1998","journal-title":"J Immunol"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.014738"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2007.03193.x"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0906-6705.2004.00098.x"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1747.2003.12178.x"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13049"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090874"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041810"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20142944"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.5867\/medwave.2015.11.6350"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpde.13688","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.13688","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T10:44:16Z","timestamp":1694861056000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.13688"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,15]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/pde.13688"],"URL":"https:\/\/doi.org\/10.1111\/pde.13688","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,15]]},"assertion":[{"value":"2018-10-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}