Didona Dario, Caposiena Caro Raffaele Dante, Calabrese Laura, D'Onghia Martina, Galluccio Giulia, Di Nicola Matteo Riccardo, Rallo Alessandra, Paolino Giovanni
Rare Skin Diseases Center, Istituto Dermopatico dell'Immacolata, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.
Dermatologic Clinic, Hospital Maggiore of Trieste, University of Trieste, 34127 Trieste, Italy.
Medicina (Kaunas). 2025 Jun 8;61(6):1056. doi: 10.3390/medicina61061056.
Lichen planus (LP) is a chronic inflammatory disorder affecting approximately 1% of the population. It presents with a wide range of clinical manifestations, mainly involving the skin, mucosal surfaces, and skin appendages, and is often characterized by a relapsing course and variable response to treatment. Although several therapeutic strategies are available, many are off-label and show limited efficacy in resistant forms. Increasing evidence points to the central role of the JAK/STAT signaling pathway in the immunopathogenesis of LP, with cytokines such as interferon-gamma and interleukin-21 playing key roles in sustaining chronic inflammation. Based on this rationale, Janus kinase (JAK) inhibitors have recently been proposed as potential therapeutic agents in LP. This review explores the biological basis for their use and systematically summarizes the existing clinical evidence on the use of JAK inhibitors in cutaneous, mucosal, appendageal, and nail variants of LP. The preliminary data suggests favorable outcomes in many patients with difficult-to-treat disease, with an acceptable safety profile. Further prospective trials are needed to establish their definitive role in the management of LP.
扁平苔藓（LP）是一种慢性炎症性疾病，影响约1%的人口。它具有广泛的临床表现，主要累及皮肤、黏膜表面和皮肤附属器，其特点通常是病程复发且对治疗反应不一。尽管有多种治疗策略可供选择，但许多都是超说明书用药，并且在耐药形式中疗效有限。越来越多的证据表明，JAK/STAT信号通路在LP的免疫发病机制中起核心作用，诸如γ-干扰素和白细胞介素-21等细胞因子在维持慢性炎症中起关键作用。基于这一理论基础，最近有人提出Janus激酶（JAK）抑制剂可作为LP的潜在治疗药物。本综述探讨了其应用的生物学基础，并系统总结了关于JAK抑制剂在LP的皮肤、黏膜、附属器和指甲病变中应用的现有临床证据。初步数据表明，许多难治性疾病患者使用JAK抑制剂可取得良好疗效，且安全性可接受。需要进一步的前瞻性试验来确定它们在LP治疗中的明确作用。
