Case Report: A novel KRT74 variant in an eight-year-old boy with alopecia totalis successfully treated with baricitinib

Alopecia areata is an autoimmune condition characterized by non-scarring hair loss, with genetic factors playing a significant role in disease susceptibility. We report the case of an 8-year-old boy with alopecia totalis harboring a heterozygous KRT74 variant. While his mother and brother share this...

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Main Authors: Yidong Tan, Jinxiang Yang, Xuanyi Chen, Yihang Shen, Zhe Wu, Weinan Zhou, Zhirong Yao, Jingjun Zhao, Jianying Liang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1574656/full
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author Yidong Tan
Yidong Tan
Jinxiang Yang
Jinxiang Yang
Xuanyi Chen
Xuanyi Chen
Yihang Shen
Yihang Shen
Zhe Wu
Zhe Wu
Weinan Zhou
Weinan Zhou
Zhirong Yao
Zhirong Yao
Jingjun Zhao
Jingjun Zhao
Jianying Liang
Jianying Liang
author_facet Yidong Tan
Yidong Tan
Jinxiang Yang
Jinxiang Yang
Xuanyi Chen
Xuanyi Chen
Yihang Shen
Yihang Shen
Zhe Wu
Zhe Wu
Weinan Zhou
Weinan Zhou
Zhirong Yao
Zhirong Yao
Jingjun Zhao
Jingjun Zhao
Jianying Liang
Jianying Liang
author_sort Yidong Tan
collection DOAJ
description Alopecia areata is an autoimmune condition characterized by non-scarring hair loss, with genetic factors playing a significant role in disease susceptibility. We report the case of an 8-year-old boy with alopecia totalis harboring a heterozygous KRT74 variant. While his mother and brother share this variant, they do not exhibit alopecia. Immunofluorescence analysis revealed increased phosphorylation of the JAK1-STAT1 pathway and elevated T cell infiltration, predominantly CD4+ T helper cells, in the proband’s scalp. The patient responded favorably to baricitinib treatment (2 mg/day), showing significant hair regrowth within 1 month and continued improvement over 8 months. This case suggests that KRT74 variants may contribute to immune dysregulation in alopecia areata, highlighting the potential role of JAK inhibitors in genetically predisposed alopecia cases.
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institution Kabale University
issn 2296-858X
language English
publishDate 2025-07-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-e53e4b03dcc0410da08a9a6c94102cb92025-08-20T03:51:08ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15746561574656Case Report: A novel KRT74 variant in an eight-year-old boy with alopecia totalis successfully treated with baricitinibYidong Tan0Yidong Tan1Jinxiang Yang2Jinxiang Yang3Xuanyi Chen4Xuanyi Chen5Yihang Shen6Yihang Shen7Zhe Wu8Zhe Wu9Weinan Zhou10Weinan Zhou11Zhirong Yao12Zhirong Yao13Jingjun Zhao14Jingjun Zhao15Jianying Liang16Jianying Liang17Department of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaAlopecia areata is an autoimmune condition characterized by non-scarring hair loss, with genetic factors playing a significant role in disease susceptibility. We report the case of an 8-year-old boy with alopecia totalis harboring a heterozygous KRT74 variant. While his mother and brother share this variant, they do not exhibit alopecia. Immunofluorescence analysis revealed increased phosphorylation of the JAK1-STAT1 pathway and elevated T cell infiltration, predominantly CD4+ T helper cells, in the proband’s scalp. The patient responded favorably to baricitinib treatment (2 mg/day), showing significant hair regrowth within 1 month and continued improvement over 8 months. This case suggests that KRT74 variants may contribute to immune dysregulation in alopecia areata, highlighting the potential role of JAK inhibitors in genetically predisposed alopecia cases.https://www.frontiersin.org/articles/10.3389/fmed.2025.1574656/fullalopecia totalisKRT74 variantJAK1-STAT1 pathwayleukonychiabaricitinib
spellingShingle Yidong Tan
Yidong Tan
Jinxiang Yang
Jinxiang Yang
Xuanyi Chen
Xuanyi Chen
Yihang Shen
Yihang Shen
Zhe Wu
Zhe Wu
Weinan Zhou
Weinan Zhou
Zhirong Yao
Zhirong Yao
Jingjun Zhao
Jingjun Zhao
Jianying Liang
Jianying Liang
Case Report: A novel KRT74 variant in an eight-year-old boy with alopecia totalis successfully treated with baricitinib
Frontiers in Medicine
alopecia totalis
KRT74 variant
JAK1-STAT1 pathway
leukonychia
baricitinib
title Case Report: A novel KRT74 variant in an eight-year-old boy with alopecia totalis successfully treated with baricitinib
title_full Case Report: A novel KRT74 variant in an eight-year-old boy with alopecia totalis successfully treated with baricitinib
title_fullStr Case Report: A novel KRT74 variant in an eight-year-old boy with alopecia totalis successfully treated with baricitinib
title_full_unstemmed Case Report: A novel KRT74 variant in an eight-year-old boy with alopecia totalis successfully treated with baricitinib
title_short Case Report: A novel KRT74 variant in an eight-year-old boy with alopecia totalis successfully treated with baricitinib
title_sort case report a novel krt74 variant in an eight year old boy with alopecia totalis successfully treated with baricitinib
topic alopecia totalis
KRT74 variant
JAK1-STAT1 pathway
leukonychia
baricitinib
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1574656/full
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