What is your preferred treatment algorithm for a patient with alopecia universalis who has failed oral and intralesional steroids?

My treatment ladder for severe AA is:

• Potent topical steroid under occlusion
• Contact sensitization therapy
• Oral Jak inhibitor
• Addition of low-dose oral minoxidil after 3 months if no response

I sometimes use oral steroids for acute progressive disease. I do not think ILK is practical for severe d...

Jaks are now state-of-the-art if there are no contraindications. There are now 2 approved Jaks.

An oral JAK inhibitor! I often start low-dose oral minoxidil concomitantly.