원형탈모에서 저용량 경구 미녹시딜 투여의 효과와 안전성: 후향적 단일기관 분석 = Efficacy and Safety of Low-Dose Oral Minoxidil in Alopecia Areata: A Retrospective Single-Center Analysis

다국어 초록 (Multilingual Abstract)

Background: Oral minoxidil (OM) is increasingly used as an off-label therapeutic option for moderate-to-severe alopecia areata (AA), particularly in patients who are unresponsive to conventional systemic agents or Janus kinase (JAK) inhibitors. However, well-structured clinical data regarding its efficacy, add-on benefits, and long-term safety are limited.
Objective: To evaluate the therapeutic outcomes and safety of low-dose OM in patients with AA and investigate the synergistic efficacy of sequential OM add-on therapy in patients with insufficient response to JAK inhibitors.
Methods: This retrospective study analyzed 109 adult patients with AA treated with low-dose OM at Chungnam National University Hospital from March 2019 to October 2025. Disease severity was assessed using the Severity of Alopecia Tool (SALT) score. The primary outcome was the change in SALT score. Safety profiles and adverse events were comprehensively reviewed.
Results: The mean treatment duration was 19.0±16.0 months. Significant improvement in SALT scores was observed in the overall cohort (46.3 to 28.3, p＜0.001). In the subgroup analysis of patients with an insufficient response to JAK inhibitor monotherapy, the addition of OM resulted in a further reduction in the SALT score by 32.3 points (p=0.004). The most frequent adverse event was hypertrichosis (3.7%); no serious adverse events or treatment-limiting toxicities were observed.
Conclusion: Low-dose OM is an effective and well-tolerated treatment option for severe AA. Notably, sequential add-on therapy with JAK inhibitors demonstrated robust synergistic effects, suggesting that it is a viable strategy for refractory cases, while minimizing discontinuation due to adverse events.