INTRODUCTION
Janus kinase (JAK) inhibitors are increasingly prescribed for inflammatory and autoimmune diseases, including atopic dermatitis (AD), alopecia areata (AA), psoriasis/psoriatic arthritis (PsO/PsA), and inflammatory bowel disease (IBD).1-2 Their use has expanded nearly fourfold in recent years, driven by their efficacy and rapid onset of action. JAK inhibitors modulate immune activation by blocking the JAK–STAT signaling cascade, dampening proinflammatory cytokine activity, and providing targeted disease control for chronic immune-mediated disorders.2
JAK inhibitors are associated with a spectrum of adverse events, including infections, laboratory abnormalities, cardiovascular events, gastrointestinal symptoms, acne, and malignancy.1-2 Acne is one of the most frequently reported, with incidence varying across different agents, highest with abrocitinib, followed by baricitinib, upadacitinib, ritlecitinib, and tofacitinib.3-4 Drug-induced acne typically presents as a monomorphic papulopustular eruption involving the face, chest, or trunk, and may occur de novo in patients without prior acne history.4-5
Despite rising clinical relevance, the clinical features, timing, distribution, and patient characteristics associated with JAK-inhibitor–induced acne remain poorly defined, with most available evidence derived from clinical trials or small case series.1-5 Real-world characterization across multiple JAK inhibitors is limited. This study aims to describe the demographic, clinical features, time to onset, anatomic distribution, and treatment responses of acne in patients receiving oral JAK inhibitors at a large academic dermatology center.
JAK inhibitors are associated with a spectrum of adverse events, including infections, laboratory abnormalities, cardiovascular events, gastrointestinal symptoms, acne, and malignancy.1-2 Acne is one of the most frequently reported, with incidence varying across different agents, highest with abrocitinib, followed by baricitinib, upadacitinib, ritlecitinib, and tofacitinib.3-4 Drug-induced acne typically presents as a monomorphic papulopustular eruption involving the face, chest, or trunk, and may occur de novo in patients without prior acne history.4-5
Despite rising clinical relevance, the clinical features, timing, distribution, and patient characteristics associated with JAK-inhibitor–induced acne remain poorly defined, with most available evidence derived from clinical trials or small case series.1-5 Real-world characterization across multiple JAK inhibitors is limited. This study aims to describe the demographic, clinical features, time to onset, anatomic distribution, and treatment responses of acne in patients receiving oral JAK inhibitors at a large academic dermatology center.
MATERIALS AND METHODS
We performed a retrospective chart review of patients seen in dermatology with a diagnosis of acne treated at the Icahn School of Medicine at Mount Sinai between March 2020 and March 2024. Patients were included if they were prescribed an oral JAK inhibitor (tofacitinib, baricitinib, upadacitinib, abrocitinib, or ritlecitinib) and had a documented diagnosis of acne vulgaris. Data reviewed included demographic characteristics, body mass index (BMI), race/ethnicity, treatment indication, JAK inhibitor agent, duration of therapy, time to acne onset, acne clinical morphology, anatomic distribution, and treatment response.
