Cargando…
Tofacitinib Treatment of Refractory Cutaneous Leukocytoclastic Vasculitis: A Case Report
INTRODUCTION: To date, there is no treatment with proven efficacy for cutaneous leukocytoclastic vasculitis (CLV). Several reports have suggested that CLV responds favorably to corticosteroids, colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs), azathioprine, and hydroxychloroquine (HCQ). To...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264360/ https://www.ncbi.nlm.nih.gov/pubmed/34248994 http://dx.doi.org/10.3389/fimmu.2021.695768 |
_version_ | 1783719538500567040 |
---|---|
author | Zhu, Kai-Jun Yang, Pei-Dan Xu, Qiang |
author_facet | Zhu, Kai-Jun Yang, Pei-Dan Xu, Qiang |
author_sort | Zhu, Kai-Jun |
collection | PubMed |
description | INTRODUCTION: To date, there is no treatment with proven efficacy for cutaneous leukocytoclastic vasculitis (CLV). Several reports have suggested that CLV responds favorably to corticosteroids, colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs), azathioprine, and hydroxychloroquine (HCQ). To the best of our knowledge, the oral small molecule Janus kinase inhibitor, tofacitinib, plays an important role in the treatment of autoimmune and inflammatory diseases. Therefore, tofacitinib may be a prospective therapy in patients with CLV. CASE PRESENTATION: A 29-year-old woman presented to our hospital with a 5-year history of symmetric skin lesions mainly affecting both lower extremities. The results for anti-neutrophil cytoplasmic antibodies (ANCA), anti-extracted nuclear antigens (ENA) autoantibodies, anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies, and antinuclear antibodies (ANA) were all negative. The definite diagnosis of CLV was determined by a skin biopsy. However, the patient exhibited a poor response to prednisone, HCQ, methotrexate, colchicine, azathioprine, and tripterygium wilfordii polyglycoside tablets (TGTs) treatments. She was then treated with oral tofacitinib (5 mg twice daily) and oral prednisone (25 mg daily). OUTCOMES: Her skin lesions gradually improved over a period of 4 weeks. Two months later, the skin ulcers completely resolved. No evidence of recurrence of skin ulcers was observed during a 6-month follow-up. CONCLUSION: We present the first case of a female patient receiving short-term tofacitinib therapy for refractory CLV. Tofacitinib may be a promising oral alternative for patients with CLV. However, its efficacy and safety require further appraisal through clinical trials. |
format | Online Article Text |
id | pubmed-8264360 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82643602021-07-09 Tofacitinib Treatment of Refractory Cutaneous Leukocytoclastic Vasculitis: A Case Report Zhu, Kai-Jun Yang, Pei-Dan Xu, Qiang Front Immunol Immunology INTRODUCTION: To date, there is no treatment with proven efficacy for cutaneous leukocytoclastic vasculitis (CLV). Several reports have suggested that CLV responds favorably to corticosteroids, colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs), azathioprine, and hydroxychloroquine (HCQ). To the best of our knowledge, the oral small molecule Janus kinase inhibitor, tofacitinib, plays an important role in the treatment of autoimmune and inflammatory diseases. Therefore, tofacitinib may be a prospective therapy in patients with CLV. CASE PRESENTATION: A 29-year-old woman presented to our hospital with a 5-year history of symmetric skin lesions mainly affecting both lower extremities. The results for anti-neutrophil cytoplasmic antibodies (ANCA), anti-extracted nuclear antigens (ENA) autoantibodies, anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies, and antinuclear antibodies (ANA) were all negative. The definite diagnosis of CLV was determined by a skin biopsy. However, the patient exhibited a poor response to prednisone, HCQ, methotrexate, colchicine, azathioprine, and tripterygium wilfordii polyglycoside tablets (TGTs) treatments. She was then treated with oral tofacitinib (5 mg twice daily) and oral prednisone (25 mg daily). OUTCOMES: Her skin lesions gradually improved over a period of 4 weeks. Two months later, the skin ulcers completely resolved. No evidence of recurrence of skin ulcers was observed during a 6-month follow-up. CONCLUSION: We present the first case of a female patient receiving short-term tofacitinib therapy for refractory CLV. Tofacitinib may be a promising oral alternative for patients with CLV. However, its efficacy and safety require further appraisal through clinical trials. Frontiers Media S.A. 2021-06-24 /pmc/articles/PMC8264360/ /pubmed/34248994 http://dx.doi.org/10.3389/fimmu.2021.695768 Text en Copyright © 2021 Zhu, Yang and Xu 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 | Immunology Zhu, Kai-Jun Yang, Pei-Dan Xu, Qiang Tofacitinib Treatment of Refractory Cutaneous Leukocytoclastic Vasculitis: A Case Report |
title | Tofacitinib Treatment of Refractory Cutaneous Leukocytoclastic Vasculitis: A Case Report |
title_full | Tofacitinib Treatment of Refractory Cutaneous Leukocytoclastic Vasculitis: A Case Report |
title_fullStr | Tofacitinib Treatment of Refractory Cutaneous Leukocytoclastic Vasculitis: A Case Report |
title_full_unstemmed | Tofacitinib Treatment of Refractory Cutaneous Leukocytoclastic Vasculitis: A Case Report |
title_short | Tofacitinib Treatment of Refractory Cutaneous Leukocytoclastic Vasculitis: A Case Report |
title_sort | tofacitinib treatment of refractory cutaneous leukocytoclastic vasculitis: a case report |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264360/ https://www.ncbi.nlm.nih.gov/pubmed/34248994 http://dx.doi.org/10.3389/fimmu.2021.695768 |
work_keys_str_mv | AT zhukaijun tofacitinibtreatmentofrefractorycutaneousleukocytoclasticvasculitisacasereport AT yangpeidan tofacitinibtreatmentofrefractorycutaneousleukocytoclasticvasculitisacasereport AT xuqiang tofacitinibtreatmentofrefractorycutaneousleukocytoclasticvasculitisacasereport |