Rapid response of hand eczema with psoriasis overlap to upadacitinib

Palmoplantar psoriasis is a clinical form of psoriasis that can represent a diagnostic challenge due to its clinical and histological similarity to hand eczema. The concomitant presentation of both pathologies is uncommon and has a limited response to common treatments. The four isoforms of Janus kinases (JAK) are crucial intracellular mediators associated with cytokine receptors. Upadacitinib has been approved for several diseases, including psoriatic arthritis and atopic dermatitis, and has demonstrated efficacy in psoriasis vulgaris as a secondary endpoint in patients with psoriatic arthritis. We present a case of overlapping psoriasis/chronic hand eczema that, after several therapeutic failures, obtained an excellent clinical response to upadacitinib.