Case Report: Multimodal contact immunotherapy in alopecia areata: long-term clinical experience in the JAK inhibitor era.

Introduction: Alopecia areata (AA) poses a significant therapeutic challenge. While biologics and Janus kinase (JAK) inhibitors offer novel treatment options, immunotherapy remains a relevant approach. This case series describes the long-term clinical experience and the 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 demonstrating long-term safety. Results: All patients achieved sustained long-term disease control with a multimodal approach. Conclusion: 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 demonstrates that traditional immunotherapy continues to be a valuable treatment option for alopecia areata.