Abstract
Alopecia totalis (AT) is an autoimmune condition and severe form of alopecia areata characterized by complete scalp hair loss, often posing treatment challenges, especially in pediatric patients. This case report presents a 7-year-old boy with a 2-year history of alopecia, who developed AT. The patient initially showed limited response to a combination of Wysolone (prednisolone) and methotrexate. The introduction of topical tofacitinib along with mometasone resulted in significant hair regrowth and improvement in hair density over a 4-month period. This case highlights the potential of topical Janus kinase inhibitors as a promising treatment for the pediatric patient with AT.