P87 Hitting two targets with one arrow: successful treatment of psoriasiform dermatitis with upadacitinib

Abstract Psoriasiform dermatitis is a chronic, inflammatory condition that resembles psoriasis and is characterized by scaly, erythematous plaques. It can be challenging to treat as traditional treatments such as topical corticosteroids, phototherapy and systemic agents often fail or present significant side effects. This case study explores the successful treatment of a female patient with psoriasiform dermatitis using upadacitinib, a (JAK1) selective Janus kinase inhibitor. A 52-year-old female, with a 5-year history of psoriasiform dermatitis, histologically proven, presented to the outpatient department of dermatology exhibiting extensive lesions on trunk, back, arms and legs accompanied by severe itching. Anterior treatments, including topical and oral steroids, methotrexate, cyclosporine, narrowband UVB, omalizumab and secukinumab provided minimal relief. Additionally, our patient experienced an important discomfort and a reduced quality of life during all these years due to the persistent nature of her disease. Due to the fact that the ultimate EASI score (Eczema Area and Severity Index) and IGE (Immunoglobulin E) were very high, we decided to initiate upadacitinib in a dosage of 30 mg/day. Our patient reported great improvement in the pruritus within 5 days of receiving upadacitinib. Clinical evaluation marked a significant reduction of scaling and erythema, as well, at Week 4. By the 12th week, the patient achieved complete clearance with no adverse events reported. Furthermore, her emotional well-being and quality of life were improved. This case demonstrates that upadacitinib can be a well-tolerated and rapid treatment option for patients with psoriasiform dermatitis who are refractory to other conventional therapies. Its ability to modulate the immune response may offer a promising therapeutic approach for managing chronic inflammatory skin diseases.