Tina Bhutani, MD

A talk titled ‘Alopecia Areata: New Therapies’ was held at the 

2025 American Academy of Dermatology (AAD) Annual Meeting

 in Orlando, during which Tina Bhutani-Jaqcues, MD, is speaking on the topic of Janus Kinase (JAK) inhibitors and data on use with 

Bhutani is a board-certified dermatologist, a fellow of the AAD, and a clinical researcher at the University of California, San Francisco. Bhutani spoke in an interview with 

 at AAD 2025 regarding her talk’s biggest takeaways for clinicians who are curious about JAK inhibitor safety during pregnancy.

Guidance on JAK Inhibitors for Alopecia Areata During Pregnancy

Guidance on JAK Inhibitors for Alopecia Areata During Pregnancy, with Tina Bhutani, MD

“This was a talk that I was invited to give at the alopecia areata forum, and the reason for that is that we're using a lot of JAK inhibitors, not only for alopecia areata, but also for other diseases like atopic dermatitis,” Bhutani explained. “Unlike other disease states, where our patients might be older or lactation might not be of concern, patients with alopecia areata and atopic dermatitis are actually younger. So these questions and these considerations are going to come into play, and we're probably going to have to have these conversations more often.”

Bhutani highlighted several key points from her portion of the presentation, noting that she reviewed the little data available on JAK inhibitor use during pregnancy. In light of this research, Bhutani stressed caution.

“In most of the data that is available on the use of JAK inhibitors in pregnancy, it had to do with animal studies, because that’s where most of the data comes from,” Bhutani said. “Unfortunately, the animal studies do show that at very, very high doses of JAK inhibitors, much higher doses than what we use in humans, there is a chance for for spontaneous abortion and for congenital abnormalities. So there does seem to be a concern when it comes to animal studies.”

Bhutani highlighted additional data on upadacitinib and baracitinib for atopic dermatitis and alopecia, respectively, noting that these are the currently approved JAK inhibitors.

“There were actually some cases of patients who did become pregnant in these trials,” Bhutani said. “I looked at the data, not only in dermatology, but actually looking at cases in inflammatory bowel disease and other indications where these drugs are used, to compile all the statistics. Luckily, it shows that the rate of spontaneous abortions and the rates of congenital abnormalities that were seen in those patients are pretty similar to the general population. So even though at much higher doses in animals, we did see problems, when we look at just the normal doses of these medications in the human population, so far, there doesn't seem to be many red flags.”

However, Bhutani noted that recommendations are still to try and stop these medications before trying to become pregnant. She also noted data on breastfeeding data.

“We don't have much data when it comes to breastfeeding on these drugs,” Bhutani said. “But again, the animal studies do show that the medication seems to pass through breast milk, so it is probably not recommended to breastfeed while taking these medications.”

For additional information on this subject, view Bhutani’s full interview segment posted above. To learn more from AAD 2025, view our 

The quotes used in this interview summary were edited for clarity.

Videos

In this interview at AAD 2025, Bhutani highlights several points of consideration for clinicians treating patients who are pregnant and suffering from alopecia areata.

Dermatologists Drs Tina Bhutani and Scott Boswell and patient Kanya Oul share resources and tools available to cope with generalized pustular psoriasis (GPP).

Tips for Managing Generalized Pustular Psoriasis (GPP)

This is a video synopsis/summary of a panel discussion involving Tina Bhutani, MD; J. Scott Boswell, MD; and Kanya Oul, RN.

In the concluding segment of the discussion, Kanya emphasizes the importance of healthcare providers listening to their patients and believing their experiences. She credits her doctor with saving her life and underscores the significance of finding a reliable healthcare provider who understands the patient's condition. Kanya encourages providers to educate themselves and be proactive in referring patients for appropriate care.

The speaker echoes the importance of education, stressing the need for healthcare professionals to stay updated on advancements in their field. He emphasizes the role of primary care physicians and emergency medicine practitioners in recognizing and treating severe skin conditions like generalized pustular psoriasis (GPP). The speaker shares his proactive approach to adopting new treatments for the benefit of his patients.

Overall, the discussion highlights the importance of patient-provider communication, education, and collaboration in effectively managing conditions like GPP. The participants express gratitude for the opportunity to share their insights, underscoring the value of such discussions in improving patient care.

Video synopsis is AI-generated and reviewed by HCPLive editorial staff.

Coping With and Support for Generalized Pustular Psoriasis (GPP)

The conversation delves into coping mechanisms for dealing with autoimmune diseases, particularly psoriasis. Kanya shares her personal journey of learning to cope with the condition since childhood, highlighting the importance of social support from friends and family. She emphasizes the lack of formal therapy in her upbringing due to various factors but acknowledges the value of seeking support as an adult.

The speaker underscores the systemic nature of psoriasis and the need for comprehensive patient care beyond just treating the skin. He discusses strategies for assessing the impact of the disease on patients' lives, including open communication about symptoms and the benefits of treatment. The discussion also touches on the challenges of finding accurate information and support resources, with emphasis on the role of healthcare providers in guiding patients to evidence-based resources.

Overall, the conversation underscores the importance of social support, accurate information, and comprehensive care in managing autoimmune diseases like psoriasis. It highlights the need for healthcare providers to address the mental health impact of these conditions and guide patients to appropriate support resources.

A patient and 2 dermatologists discuss the impact of generalized pustular psoriasis (GPP) on patient’s quality of life.

Impact of Generalized Pustular Psoriasis (GPP) on the Quality of Life

The discussion centers on the profound impact of psoriasis, particularly plaque psoriasis and generalized pustular psoriasis (GPP), on patients' quality of life. The conversation explores how these conditions lead to feelings of embarrassment and stigma, affecting patients' mental health and overall well-being. Kanya, who has experienced psoriasis since childhood, shares her personal journey, highlighting the challenges of managing flare-ups and the persistent mental toll of living with a chronic disease.

Despite efforts to control her condition with treatments like isotretinoin, Kanya still grapples with feelings of self-consciousness and depression. She recounts instances of hiding her skin and enduring insensitive comments from others, emphasizing the ongoing struggle to feel comfortable in her own body. Even during periods of remission, Kanya experiences lingering reminders of her condition, such as post-inflammatory hyperpigmentation, which further affects her confidence and self-image.

The speaker acknowledges the complex interplay between physical symptoms and mental health, noting the heightened prevalence of depression and anxiety among psoriasis patients. He stresses the importance of addressing these psychological aspects in patient care, advocating for comprehensive support that includes mental health interventions alongside medical treatment.

The dialogue underscores the need for healthcare providers to consider the holistic impact of psoriasis on patients' lives, beyond just the physical symptoms. By recognizing and addressing the emotional and psychological toll of the disease, clinicians can better support patients in managing their condition and improving their overall quality of life.

Tina Bhutani, MD

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