Multimodal Combined Use of Contact Immunotherapy in Alopecia Areata: Long-Term Clinical Experience in the JAK Inhibitor Era

Maira Elizabeth Herz Ruelas^1*Miranda Miroslava Contreras Hernández²Ilse María Salazar Herz³

• ¹Christus Muguerza Hospital Alta Especialidad, Monterrey, Mexico
• ²Universidad de Monterrey Escuela de Medicina y Ciencias de la Salud, San Pedro Garza García, Mexico
• ³Tecnologico de Monterrey Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico

INTRODUCTION Alopecia areata represents a significant therapeutic challenge. While biologics and JAK inhibitors offer novel alternatives, immunotherapy remains a relevant option. This case series describes the long-term clinical experience and practical use of contact immunotherapy in managing alopecia areata in combination with other current treatment modalities. METHODS We present five patients with chronic alopecia areata who have been successfully treated with topical immunotherapy for 9-15 years in combination with other treatments, achieving excellent disease control and long-term safety. RESULTS All patients presented sustained disease control over the long term with a multimodal approach. DISCUSSION This case series highlights the enduring value of topical immunotherapy, even in the era of novel targeted therapies. It underscores the importance of individualized, multimodal approaches to optimize patient outcomes and highlights that classic immunotherapy remains a valuable treatment option in alopecia areata.