Abrocitinib for Head and Neck Dermatitis: Case Series and Literature Review

Head and neck dermatitis (HND) is a recalcitrant subtype of atopic dermatitis (AD). Despite conventional therapies, including topical corticosteroids, calcineurin inhibitors, and biologics such as dupilumab, many patients remain refractory to treatment. Janus kinase (JAK) inhibitors, such as abrocitinib, offer a novel therapeutic approach targeting multiple inflammatory pathways implicated in HND.

To evaluate the efficacy of abrocitinib in refractory HND and compare its effectiveness with other JAK inhibitors (upadacitinib, baricitinib).

We retrospectively analyzed three patients with HND treated with abrocitinib (100-200 mg/day). Treatment response was assessed using Eczema Area and Severity Index (EASI) scores and the Investigator's Global Assessment (IGA) of the head and neck. A PubMed literature review was conducted to compare abrocitinib with other JAK inhibitors in HND.

All three abrocitinib-treated patients achieved rapid skin lesion relief within 1-2 weeks and near-complete lesion clearance by Week 8. These results are consistent with clinical trial data highlighting the strong early efficacy of JAK inhibitors for head and neck lesions. While abrocitinib and upadacitinib demonstrated robust clinical responses, baricitinib showed comparatively weaker efficacy in the head and neck.

JAK inhibitors, particularly abrocitinib and upadacitinib, may be considered as first-line therapies for refractory HND. They offer both rapid symptom relief and sustained efficacy.