Successful Treatment of Linear Porokeratosis with Ivarmacitinib in an Adolescent: A Case Report

Porokeratosis is a rare cutaneous disorder of keratinization, and its linear variant typically follows the lines of Blaschko. We report a case of a 15-year-old female patient with a 3-year history of a linear eruption on her right waist and thigh, accompanied by severe pruritus. Previous interventions, including topical corticosteroids, antihistamines, and oral prednisone, had failed to produce clinical improvement. The diagnosis of linear porokeratosis was confirmed after histopathological examination revealed the characteristic cornoid lamella. The patient was prescribed ivarmacitinib at a dose of 4 mg once daily. At the 3-month follow-up, the patient reported a significant reduction in pruritus, and clinical examination showed marked flattening of the papules, with no adverse events reported. Ivarmacitinib is a highly selective JAK1 inhibitor, and JAK1 plays a crucial role in the pathogenesis of inflammatory diseases. Ivarmacitinib was successfully utilized for the first time in the treatment of an adolescent patient with linear porokeratosis. Although the precise mechanism by which ivarmacitinib addresses linear porokeratosis has yet to be definitively elucidated, this case provides clinicians with a novel perspective and an additional option regarding pharmacological selection and therapeutic strategies.