Clearance of Cutaneous Lichen Planus with Deucravacitinib

Lichen planus (LP) is an idiopathic, immune-mediated inflammatory disorder commonly characterized by pruritic, violaceous papules and plaques that often involve the extremities. Although a variety of topical and systemic therapies are used, no targeted treatments are currently approved by the US Food and Drug Administration for this indication, and management of refractory disease remains challenging. Tyrosine kinase 2 (TYK2) inhibitors selectively modulate several cytokine signaling pathways, including interleukin (IL)-12, IL-23/IL-17, and type I interferon signaling, which are implicated in the pathogenesis of LP. Here, we report a case of biopsy-confirmed, treatment-refractory, cutaneous LP that achieved near-complete resolution after 2 months of therapy with the oral TYK2 inhibitor, deucravacitinib.