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This retrospective cohort study compares systemic inflammatory hematologic indices between severe and mild patients and healthy controls, then tracks longitudinal changes in severe disease after Janus kinase inhibitor therapy. Across 129 participants, markers such as MLR, NLR, PLR, SII, and ESR were higher in severe alopecia areata, while RDW, MPV, and CRP were not different.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/systemic-inflammation-marker-alterations-in-severe-alopecia-areata-patients-treated-with-janus-kinase-inhibitors/461650/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/systemic-inflammation-marker-alterations-in-severe-alopecia-areata-patients-treated-with-janus-kinase-inhibitors/461650.png","ImageObject",300,407,{"name":92,"@type":93},"LangkahRina","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Which systemic inflammatory markers differed between severe and mild alopecia areata?","Question",{"text":112,"@type":113},"MLR, NLR, PLR, SII, and ESR were significantly higher in the severe group than in the mild group and controls. RDW, MPV, and CRP showed no significant differences.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did inflammatory markers change over time after Janus kinase inhibitor treatment in severe patients?",{"text":117,"@type":113},"After treatment with JAK inhibitors, NLR and SII decreased significantly over time. MLR, PLR, and CRP also reduced during follow-up, while ESR and RDW remained unchanged.",{"name":119,"@type":110,"acceptedAnswer":120},"What does the study conclude about the role of systemic inflammation in alopecia areata?",{"text":121,"@type":113},"Systemic inflammatory markers are elevated in severe alopecia areata. Longitudinal changes after JAK inhibitor therapy suggest an association with disease severity and clinical improvement, rather than definitive predictive biomarkers.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},461650,1790814324,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090893776,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Article  \nSystemic Inflammation Marker Alterations in Severe Alopecia Areata Patients Treated with Janus Kinase Inhibitors  \nGokhan Sahin *, Fatma Aydin and Esra Pancar Yuksel  \nAcademic Editor: Alexander C. Katoulis  \nReceived: 1 December 2025  \nRevised: 27 December 2025  \nAccepted: 3 January 2026  \nPublished: 5 January 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \nDepartment of Dermatology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55139, Türkiye;  \n[faydin@omu.edu.tr](faydin@omu.edu.tr) (F.A.); [esra.pyuksel@omu.edu.tr](esra.pyuksel@omu.edu.tr) (E.P.Y.)  \n* Correspondence: [gokhan.sahin@omu.edu.tr](gokhan.sahin@omu.edu.tr); Tel.: +90-362-312-1919  \nAbstract  \nBackground/Objectives: Alopecia areata is an autoimmune disorder characterized by nonscarring hair loss and systemic immune dysregulation. Hematological indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-tolymphocyte ratio (MLR), mean platelet volume (MPV), systemic immune-inflammation index (SII), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) have been associated with inflammatory activity in dermatologic diseases. This study aimed to compare systemic inflammatory markers among patients with severe and mild alopecia areata and healthy controls, and to explore longitudinal changes in these markers in patients with severe disease who achieved clinical improvement following Janus kinase (JAK) inhibitor therapy. Methods: This retrospective cohort study included 129 participants:  \n43 patients with severe alopecia areata (SALT ≥ 50) treated with JAK inhibitors who achieved documented clinical improvement, 43 patients with mild disease (SALT ≤ 20), and 43 age-and sex-matched healthy controls. Hematological inflammatory markers, including red cell distribution width (RDW), MPV, MLR, NLR, PLR, SII, ESR, and CRP, were compared across groups. In patients with severe disease, longitudinal changes were assessed at baseline, three months after treatment initiation, and at the time of documented clinical improvement. Results: MLR, NLR, PLR, SII, and ESR levels were significantly higher in the severe group compared with mild cases and controls, while RDW, MPV, and CRP showed no significant differences. Among patients with severe alopecia areata who achieved clinical improvement following JAK inhibitor therapy, NLRand SII decreased significantly over time. MLR, PLR, and CRP also showed reductions during follow-up, while ESR and RDW remained unchanged. Conclusions: Systemic inflammatory markers are elevated in severe alopecia areata compared with mild disease and healthy controls. In patients who achieved clinical improvement with JAK inhibitor therapy, several inflammatory indices demonstrated longitudinal changes. These findings are exploratory and suggest an association between systemic inflammation, disease severity, and clinical improvement rather than definitive predictive biomarkers.  \nKeywords: alopecia areata; inflammatory markers; JAK inhibitors; neutrophil-tolymphocyte ratio; systemic immune-inflammation index  \n1. Introduction  \nAlopecia areata is a chronic dermatological condition driven by immune system dysregulation. It causes nonscarring hair loss by specifically targeting hair follicles in the anagen phase. While the scalp is the primary site of involvement, alopecia areata may also  \nlead to hair loss in other regions such as the eyebrows, eyelashes, beard, and various parts of the body. At any given time, the condition is seen in about 0.1% of the population, and the estimated lifetime risk is around 2%[1] .  \nThe underlying mechanisms of alopecia areata have not been fully clarified. However, current evidence suggests that in genetically predisposed individuals, a breakdown in the immune privilege of the hair follicle all","cbCaijVXKhE7yCcu","https://ap.wps.com/l/cbCaijVXKhE7yCcu","pdf",220592,"English","# Introduction\n## Alopecia areata and immune dysregulation\n## Systemic inflammation and hematological indices\n# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions","[{\"question\":\"Which systemic inflammatory markers differed between severe and mild alopecia areata?\",\"answer\":\"MLR, NLR, PLR, SII, and ESR were significantly higher in the severe group than in the mild group and controls. RDW, MPV, and CRP showed no significant differences.\"},{\"question\":\"How did inflammatory markers change over time after Janus kinase inhibitor treatment in severe patients?\",\"answer\":\"After treatment with JAK inhibitors, NLR and SII decreased significantly over time. MLR, PLR, and CRP also reduced during follow-up, while ESR and RDW remained unchanged.\"},{\"question\":\"What does the study conclude about the role of systemic inflammation in alopecia areata?\",\"answer\":\"Systemic inflammatory markers are elevated in severe alopecia areata. Longitudinal changes after JAK inhibitor therapy suggest an association with disease severity and clinical improvement, rather than definitive predictive biomarkers.\"}]","Systemic Inflammation Marker Alterations in Severe Alopecia Areata Patients Treated with Janus Kinase Inhibitors | PDF",1790762058,25]