Alleviation of isolated nail lichen planus by the JAK1/2 inhibitor Baricitinib: a case report

Figures & data

Figure 1. The clinical manifestations of the patient and histopathology of the nail biopsy: (A) the appearance of right fingernail before treatment, we can see typical sings of longitudinal ridging, splitting (star), onychoschizia, onycholysis, subungual hyperkeratosis (arrow) and splinter hemorrhage (triangle). (B) Complete clearance after 6 months of treatment with baricitinib, 4 mg, daily. (C–D) The biopsy specimen showing a band of lymphocytes infiltrate around the matrix and the eponychium, with focal hyperkeratosis, hypergranulosis, vacuolar basal cell degeneration and lack of spongiosis. Hematoxylin-eosin, original magnification ×50 and ×200, respectively.

Table 1. JAK inhibitor for NLP cases reported to date.

First author (year of publication)	Age of patient (years)	Concomitant Diseases	Duration (year)	Treatment Previously	JAK inhibitor	Outcome	Recurrence	Adverse events
Pünchera (2021) (11)	60s	N	1	intramuscular triamcinolone; oral acitretin; methotrexate;	Baricitinib	CR	Slight recurrence after dose reduction	N
Iorizzo (2022) (10)	57	hypothyroidism; rheumatoid arthritis and alopecia areata	1	intralesional nail matrix injections; Methotrexate; alitretinoin	Tofacitinib	CR	N	N
Our case (2023)	30s	N	2	tropical therapy; oral acitretin	Baricitinib	CR	N	N

N: No; CR: Complete Resolution.

Pünchera J, Laffitte E. Treatment of severe nail lichen planus with baricitinib. JAMA Dermatol. 2022;158(1):107–108. doi:10.1001/jamadermatol.2021.5082.

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Iorizzo M, Haneke E. Tofacitinib as treatment for nail lichen planus associated with alopecia universalis. JAMA Dermatol. 2021;157(3):352–353. doi:10.1001/jamadermatol.2020.4555.

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Data availability statement

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.