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Upadacitinib in the treatment of a patient with the triad of atopic dermatitis; vitiligo; and alopecia areata: a case report and literature review
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DOI：10.3389/fimmu.2026.1795986.png)
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Abstract
En 中文
BackgroundThe simultaneous occurrence of severe atopic dermatitis (AD); vitiligo; and alopecia areata (AA) in a single patient is exceptionally rare and poses a significant therapeutic challenge; as conventional “disease-specific” therapies often yield suboptimal results. Emerging evidence implicates the shared JAK-STAT signaling pathway in the pathogenesis of these conditions; suggesting the potential for a targeted “multi-disease therapy” approach.Case presentationA 57-year-old man presented with severe; treatment-refractory AD; extensive vitiligo; and AA. Following the failure of conventional therapies; treatment with the selective JAK1 inhibitor upadacitinib (15 mg daily) was initiated. A rapid and marked improvement was observed: pruritus subsided within days; AD-related erythema cleared substantially by 15 weeks; complete eyebrow regrowth occurred within months; and significant repigmentation of vitiligo lesions was evident at one-year follow-up. The treatment was well-tolerated.ConclusionThis case suggests that upadacitinib monotherapy may be an effective and well-tolerated option for severe co-existing AD; vitiligo; and AA. It provides clinical evidence supporting the novel “multi-disease therapy” paradigm; which targets common pathogenic pathways rather than individual disease phenotypes; offering a new strategic direction for managing complex immune-mediated comorbidities.
Keywords:
vitiligo
atopic dermatitis
upadacitinib
alopecia areata
JAK-STAT pathway
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