
Alopecia areata [AA] is a chronic, immune-mediated hair loss disorder affecting approximately 2% of the global population across all ages, sexes, and ethnicities [1,2] It is driven by a collapse of immune privilege at the hair follicle, mediated primarily by autoreactive CD8+ T cells and the JAK-STAT signaling pathway.[3,4] Clinically, AA gifts as well-demarcated, non-scarring patches of hair loss that may development to total scalp hair loss [alopecia totalis] or complete body hair loss [alopecia universalis].[5] Diagnosis is predominantly clinical, supported by dermoscopy and, in uncertain cases, histopathology. Treatment has been historically limited but has undergone a paradigm shift with the FDA approval of JAK inhibitors—baricitinib [2022] and ritlecitinib [2023]—representing the first disease-modifying therapies for this condition.[6,7] Beyond clinical manifestations, AA imposes a significant psychosocial burden, with high rates of depression, anxiety, and impaired quality of life.[8,9]. This review manufactures current knowledge on the epidemiology, immunopathogenesis, diagnostic approaches, therapeutic landscape, and psychosocial dimensions of AA, with emphasis on emerging research directions.
alopecia areata, JAK inhibitors, immune privilege, hair follicle, autoimmune dermatology, baricitinib, ritlecitinib, psychosocial impact
alopecia areata, JAK inhibitors, immune privilege, hair follicle, autoimmune dermatology, baricitinib, ritlecitinib, psychosocial impact
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