Journal Article

Upadacitinib in the treatment of a patient with the triad of atopic dermatitis, vitiligo, and alopecia areata: a case report and literature review

Tingting Wang, Tao Wang, Kaiwen Zhuang, Xiaofang Zhang, Jingping Wang

2026

Overview

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.

• Publisher: Frontiers Media S.A
• Subject: alopecia areata / atopic dermatitis / JAK-STAT pathway / upadacitinib / vitiligo