INTRODUCTION
Topical ruxolitinib is a potent Janus kinase (JAK) inhibitor that has demonstrated significant efficacy in treating an array of inflammatory skin conditions. While topical ruxolitinib has been most extensively studied in atopic dermatitis and vitiligo, recent reports have suggested its potential in treating other dermatoses. In this case series, we present four cases of refractory dermatological conditions that were successfully managed with topical ruxolitinib. These conditions include pediatric lichen sclerosus et atrophicus, morphea, perioral dermatitis, and notalgia paresthetica.
Case 1
A 9-year-old female presented with 6 years of recurring pruritic vaginal lichen sclerosus et atrophicus associated with occasional dysuria. Previously failed therapies included high potency topical steroids, crisaborole, and tacrolimus ointment. On exam, there was atrophy and hypopigmentation of the labia majora and minora with an erythematous patch extending from the vagina to the anus (Figure 1 A, B). Ruxolitinib 1.5% cream was applied to the affected areas twice daily for 6 weeks. On follow-up, the erythematous patch was significantly improved and the patient reported notable symptomatic improvement of both her pruritus and dysuria (Figure 1 C, D).
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A 13-year-old female with poorly controlled insulin-dependent diabetes mellitus presented with biopsy-proven morphea of the anterior lower legs, which had been present for years. Previously failed therapies included topical