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A Case of Tofacitinib-Induced Lymphomatoid Papulosis With Ocular Involvement

Calvin Knapp1, Eric Steele2, Stephanie Mengden-Koon1

  • 1Department of Dermatology, Oregon Health and Science University, Portland, OR.

The American Journal of Dermatopathology
|May 3, 2022
PubMed

Insights

Tofacitinib, a Janus kinase (JAK) inhibitor, may paradoxically induce lymphomatoid papulosis in patients. This case highlights the need for vigilance when using JAK inhibitors in dermatology.

Area of Science:

  • Dermatology
  • Immunology
  • Oncology

Background:

  • Janus kinase (JAK) inhibitors are increasingly used in dermatological treatments.
  • Tofacitinib is a commonly prescribed JAK inhibitor for various skin conditions.

Observation:

  • A patient treated with tofacitinib for erythema elevatum diutinum developed a new skin rash.
  • The rash presented as firm, violaceous papules on the trunk and extremities, with eye inflammation.

Findings:

  • Biopsies revealed CD30+ large atypical cells, indicative of lymphomatoid papulosis.
  • A potential mechanism involves persistent JAK signaling despite JAK inhibitor therapy.

Implications:

  • This case suggests a possible link between JAK inhibitors and the development of lymphomatoid papulosis.
  • Clinicians should maintain vigilance for atypical cutaneous reactions during JAK inhibitor treatment.

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