Hairy tongue associated with the use of baricitinib therapy for ophiasis pattern alopecia areata

Abstract

AbstractWe report a case of hairy tongue that developed in a young Caucasian woman during systemic baricitinib therapy for severe alopecia areata. Because she experienced good clinical regrowth of her hair during treatment, she did not want to interrupt therapy. We recommended she use a toothbrush to debride her tongue on a daily basis, which was successful. Hairy tongue most commonly occurs in elderly, debilitated males with poor oral hygiene. It is thought to occur because of overgrowth of chromogenic bacteria and/or yeast on the tongue. This unusual side effect during baricitinib therapy suggests that immune suppression may play a role. Clinicians should be aware of hairy tongue development during baracitinib therapy.