Rapid and Successful Treatment of Generalized Granuloma Annulare With Deucravacitinib

Granuloma annulare (GA) is a chronic granulomatous dermatosis that often proves resistant to conventional therapies. Increasing evidence implicates interferon-gamma-mediated JAK-STAT activation in GA pathogenesis, with tyrosine kinase 2 (TYK2) playing a central role through IL-12, IL-23, and type I interferon signaling. Deucravacitinib, a selective allosteric TYK2 inhibitor, has emerged as a potential therapy by targeting these pathways. We present the case of a 59-year-old woman with biopsy-confirmed interstitial-type GA that was unresponsive to topical corticosteroids. Initiation of deucravacitinib 6 mg daily led to complete clearance of lesions within one month. Reported adverse effects were limited to brief episodes of aphthous ulcers during the first two weeks of therapy, which resolved spontaneously. Laboratory testing two weeks after treatment initiation showed mild elevations in lipids and glucose and slightly decreased calcium, though baseline labs were not available for comparison and no serious adverse events occurred. This case highlights the potential of deucravacitinib as a novel therapeutic option for refractory GA and adds to emerging evidence that TYK2 inhibition may represent a targeted and effective approach for this condition.