A Case of Extensive Lichen Planus Treated With Deucravacitinib

Lichen planus (LP) is a persistent inflammatory condition that affects the skin and mucous membranes, often significantly impacting quality of life. Recent research has highlighted the potential of Janus kinase (JAK) inhibitors as an effective treatment for LP. We report a case of a 52-year-old woman with a history of hypertension, obesity, and hypothyroidism who presented with a widespread, itchy, and scaly rash that was present for one month and affected 80% of her body surface area (BSA). A biopsy from the right lower extremity confirmed LP. After two months of treatment with deucravacitinib, the patient demonstrated significant improvement, with BSA involvement reduced to 20% and erythema notably diminished. To our knowledge, this is the first documented case of extensive cutaneous LP successfully managed with deucravacitinib. Unlike other JAK inhibitors, deucravacitinib selectively targets tyrosine kinase 2 (Tyk2), offering focused modulation of the immune response while minimizing broader adverse effects. This specificity provides deucravacitinib with a more favorable safety profile, making it a potentially ideal option for the long-term management of chronic dermatologic conditions like LP, which often require extended treatment.