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Negative patch test findings after initiation of upadacitinib: A case report
Meghan L McPhie1,2, Melanie D Pratt1,2, Mark G Kirchhof1,2
1Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
SAGE Open Medical Case Reports
|December 17, 2024
Summary
Upadacitinib, a Janus kinase inhibitor, may affect allergic contact dermatitis patch testing. A patient on upadacitinib therapy became patch test negative, suggesting a potential impact on diagnostic results.
Area of Science:
- Immunology
- Dermatology
- Pharmacology
Background:
- Upadacitinib is a systemic Janus kinase (JAK) inhibitor approved for atopic dermatitis.
- Atopic dermatitis often co-occurs with allergic contact dermatitis (ACD).
- The impact of JAK inhibitors on ACD and patch testing is not well understood.
Observation:
- A woman in her 30s with both atopic dermatitis and ACD was treated with upadacitinib.
- Following initiation of upadacitinib therapy, the patient exhibited negative patch test results.
- This observation raises questions about JAK inhibitors' role in ACD management.
Findings:
- Upadacitinib therapy may alter immune responses relevant to allergic contact dermatitis.
- Patch test reactivity in patients with ACD might be suppressed by systemic JAK inhibition.
- The study highlights a potential confounding effect of upadacitinib on ACD diagnosis.
Implications:
- Further research is needed to clarify the effect of JAK inhibitors on ACD.
- Clinicians should consider potential immunosuppressive effects of upadacitinib on patch testing.
- Understanding this interaction is crucial for accurate ACD diagnosis and management in patients receiving JAK inhibitors.
