LAUSR

To the Editor: Alopecia areata (AA) is a common autoimmune disease. Although oral Janus kinase (JAK) inhibitors have emerged as promising targeted treatment for AA, data regarding topical JAK inhibitors are lacking. Here, we describe the results of a 24-week, openlabel, single-center pilot study of 10 patients with AA treated with tofacitinib 2% ointment applied twice daily. Inclusion criteria included $18 years of age, AA with $2 patches of scalp hair loss or complete scalp hair loss, stable or worsening disease for $6 months, and no treatment of AA for $1 month before study enrollment. All inclusion criteria are included in Supplemental Table I (available at http:// www.jaad.org). Tofacitinib was applied to half of the involved scalp, and if and when evidence of hair regrowth was observed, tofacitinib was subsequently applied to the entire involved scalp. Endpoints included regrowth of scalp hair, assessed using the Severity of Alopecia Tool (SALT), which estimates the percentage of scalp hair loss, and the time at which regrowth was first observed. Before treatment and at weeks 4 and 24 of treatment, all participants underwent laboratory evaluation, including complete blood count, comprehensive metabolic panel, and lipid panel. Follow-up visits were conducted every 4-8 weeks. This study was approved by the Yale Institutional Review Board and registered with ClinicalTrials.gov (NCT02812342). The results are summarized in Table I. The duration of the current episode of AA for patient 1 was \6 months (protocol deviation). One patient