Tofacitinib in the treatment of refractory eczemas - a case series

Janus Kinase inhibitors have been shown to be effective in the treatment of various dermatoses such as alopecia areata, psoriasis, vitiligo and atopic dermatitis. The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway is a common junction for the signaling of several dermatologically significant cytokines and the inhibition of this pathway by JAK inhibitors may be broadly useful in the treatment of various other dermatological disorders. A case series is presented of twelve patients (M:6, F:6) with a mean age 47.1 years, presenting with various eczematous dermatoses (histopathology showing spongiotic dermatitis) who had failed to respond to conventional therapy. These patients were prescribed tofacitinib. All 12 patients improved and 10 patients had improvement to clear or almost clear (physician global assessment score 0/1) after 1 month of therapy. No hematological or biochemical abnormalities were noted during the treatment period. Infections were the most common adverse events observed. Conventional treatment options like systemic steroids and steroid sparing agents are the cornerstone in the treatment of chronic eczematous disorders, however, in patients who do not respond to conventional agents, tofacitinib may represent a viable treatment option.