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Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature

Nail lichen planus (NLP) is a chronic inflammatory disease of unknown etiology and has been recognized as a nail potentially critical disorder, which can be severe and rapidly worsen with irreversible scarring. Currently, the treatment options are limited based on disease progression. High-potency t...

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Autores principales: Huang, Jundong, Shi, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687541/
https://www.ncbi.nlm.nih.gov/pubmed/38034544
http://dx.doi.org/10.3389/fmed.2023.1301123
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author Huang, Jundong
Shi, Wei
author_facet Huang, Jundong
Shi, Wei
author_sort Huang, Jundong
collection PubMed
description Nail lichen planus (NLP) is a chronic inflammatory disease of unknown etiology and has been recognized as a nail potentially critical disorder, which can be severe and rapidly worsen with irreversible scarring. Currently, the treatment options are limited based on disease progression. High-potency topical or intralesional corticosteroids are commonly considered first-line therapeutic options; however, these therapies are unsuitable for all patients with NLP, especially those with extensive lesions. As a potential therapeutic target for inflammatory skin diseases, Janus kinase (JAK) inhibitors can suppress both type-1 and type-2 cytokines, thereby reducing the immune response and resultant inflammation. Recent studies have suggested benefit in cutaneous lichen planus and lichen planopilaris with oral JAK inhibitors. Here, we report a case of severe NLP that exhibited a favorable response to tofacitinib treatment. A 41-year-old woman presented to our clinic with a 2-year history of nail dystrophy of all fingers of both hands. The NLP was finally confirmed by histopathology and the above clinical features. After the informed consent signature, tofacitinib monotherapy, 5 mg twice a day, was then begun, and after 6 months, the appearance of her nails had a significant improvement.
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spelling pubmed-106875412023-11-30 Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature Huang, Jundong Shi, Wei Front Med (Lausanne) Medicine Nail lichen planus (NLP) is a chronic inflammatory disease of unknown etiology and has been recognized as a nail potentially critical disorder, which can be severe and rapidly worsen with irreversible scarring. Currently, the treatment options are limited based on disease progression. High-potency topical or intralesional corticosteroids are commonly considered first-line therapeutic options; however, these therapies are unsuitable for all patients with NLP, especially those with extensive lesions. As a potential therapeutic target for inflammatory skin diseases, Janus kinase (JAK) inhibitors can suppress both type-1 and type-2 cytokines, thereby reducing the immune response and resultant inflammation. Recent studies have suggested benefit in cutaneous lichen planus and lichen planopilaris with oral JAK inhibitors. Here, we report a case of severe NLP that exhibited a favorable response to tofacitinib treatment. A 41-year-old woman presented to our clinic with a 2-year history of nail dystrophy of all fingers of both hands. The NLP was finally confirmed by histopathology and the above clinical features. After the informed consent signature, tofacitinib monotherapy, 5 mg twice a day, was then begun, and after 6 months, the appearance of her nails had a significant improvement. Frontiers Media S.A. 2023-11-16 /pmc/articles/PMC10687541/ /pubmed/38034544 http://dx.doi.org/10.3389/fmed.2023.1301123 Text en Copyright © 2023 Huang and Shi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Huang, Jundong
Shi, Wei
Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
title Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
title_full Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
title_fullStr Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
title_full_unstemmed Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
title_short Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
title_sort successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687541/
https://www.ncbi.nlm.nih.gov/pubmed/38034544
http://dx.doi.org/10.3389/fmed.2023.1301123
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