{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:59:41Z","timestamp":1791410381469,"version":"4.3.3"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T00:00:00Z","timestamp":1696809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Alopecia areata (AA) is a non-scarring hair loss disorder. Alopecia totalis (AT) and alopecia universalis (AU) are the severe subtypes of AA. Age of onset before 6 years of age, disease duration of more than 1 year, and extensive alopecia involving more than 50% of the scalp (including AT or AU) suggest a poorer prognosis. Topical corticosteroids are the preferred first-line treatment for pediatric AA. While some treatments, such as intralesional corticosteroids, systemic steroids, contact immunotherapy with squaric acid dibutyl ester, and JAK inhibitors, showed efficacy in adults with AA, their safety profiles limit their use in pediatric AA patients. Dupilumab is a biologic that effectively addresses the patho-physiology of Th2 allergic diseases, and treats atopic diseases by inhibiting the helper Th2 immune axis. AA has been reported to be significantly improved with dupilumab for atopic dermatitis (AD) in children and adults. We report hair regrowth over all of the scalp, eyebrows, and eyelashes after 10 months of dupilumab therapy in a 4-year-old AU patient resistant to baricitinib.<\/jats:p>","DOI":"10.3389\/fmed.2023.1253795","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T06:39:57Z","timestamp":1696833597000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Case report: Dupilumab therapy for alopecia areata in a 4-year-old patient resistant to baricitinib"],"prefix":"10.3389","volume":"10","author":[{"given":"Lu","family":"Cai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Zhuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s12016-021-08883-0","article-title":"Alopecia areata: an update on etiopathogenesis, diagnosis, and management","volume":"61","author":"Zhou","year":"2021","journal-title":"Clin Rev Allergy Immunol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3390\/cells10123397","article-title":"The role of serum Th1, Th2, and Th17 cytokines in patients with alopecia areata: clinical implications","volume":"10","author":"Wa\u015bkiel-Burnat","year":"2021","journal-title":"Cells."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1016\/j.jaci.2018.06.029","article-title":"An integrated model of alopecia areata biomarkers highlights both T(H)1 and T(H)2 upregulation","volume":"142","author":"Song","year":"2018","journal-title":"J Allergy Clini Immunol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1111\/all.13346","article-title":"Alopecia areata is characterized by expansion of circulating Th2\/Tc2\/Th22, within the skin-homing and systemic T-cell populations","volume":"73","author":"Czarnowicki","year":"2018","journal-title":"Allergy."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1016\/j.jaip.2020.01.052","article-title":"Alopecia areata is associated with atopic diathesis: results from a population-based study of 51,561 patients","volume":"8","author":"Kridin","year":"2020","journal-title":"J Allergy Clini Immunol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1056\/NEJMoa2110343","article-title":"Two phase 3 trials of baricitinib for alopecia areata","volume":"386","author":"King","year":"2022","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1111\/all.15071","article-title":"Phase 2a randomized clinical trial of dupilumab (anti-IL-4R\u03b1) for alopecia areata patients","volume":"77","author":"Guttman-Yassky","year":"2022","journal-title":"Allergy."},{"key":"B8","first-page":"39","article-title":"Monoclonal antibody therapies for atopic dermatitis: where are we now in the spectrum of disease management?","volume":"12","author":"Del Rosso","year":"2019","journal-title":"J Clini Aesthetic Dermatol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/j.jaad.2009.04.031","article-title":"History of atopy or autoimmunity increases risk of alopecia areata","volume":"61","author":"Barahmani","year":"2009","journal-title":"J Am Acad Dermatol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1111\/bjd.18008","article-title":"Alopecia areata is characterized by dysregulation in systemic type 17 and type 2 cytokines, which may contribute to disease-associated psychological morbidity","volume":"182","author":"Bain","year":"2020","journal-title":"Br J Dermatol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1111\/jcmm.12806","article-title":"Atopic dermatitis induces the expansion of thymus-derived regulatory T cells exhibiting a Th2-like phenotype in mice","volume":"20","author":"Moosbrugger-Martinz","year":"2016","journal-title":"J Cell Mol Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1016\/j.jaad.2019.06.010","article-title":"Cause or cure? Review of dupilumab and alopecia areata","volume":"88","author":"Marks","year":"2023","journal-title":"J Am Acad Dermatol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e612","DOI":"10.1111\/jdv.16493","article-title":"Alopecia areata development in atopic dermatitis patients treated with dupilumab","volume":"34","author":"St\u00e4nder","year":"2020","journal-title":"J Eur Acad Dermatol Venereolo: JEADV."},{"key":"B14","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.jdcr.2017.11.020","article-title":"Alopecia areata after dupilumab for atopic dermatitis","volume":"4","author":"Mitchell","year":"2018","journal-title":"JAAD Case Rep."},{"key":"B15","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1016\/j.alit.2022.02.006","article-title":"Development of alopecia areata-like reactions in a patient treated with dupilumab","volume":"71","author":"Yamane","year":"2022","journal-title":"Allergol Int."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1253795\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T06:40:00Z","timestamp":1696833600000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1253795\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,9]]},"references-count":15,"alternative-id":["10.3389\/fmed.2023.1253795"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1253795","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,9]]},"article-number":"1253795"}}