Wang Zhaoyang, Wang Meng, Sun Yonghu
Dermatology Hospital of Shandong First Medical University, Jinan, Shandong, China.
Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
J Dermatolog Treat. 2025 Dec;36(1):2528344. doi: 10.1080/09546634.2025.2528344. Epub 2025 Aug 4.
Janus kinase (JAK) inhibitors have emerged as targeted therapies for atopic dermatitis (AD), and increasing evidence suggests their potential benefit in vitiligo. While both diseases are considered immunologically distinct, recent insights point to overlapping cytokine pathways that may be modulated by JAK1-selective inhibitors.
We present a case of a 37-year-old male with moderate-to-severe AD and stable vitiligo who developed worsening of vitiligo following treatment with upadacitinib. Although AD symptoms resolved, vitiligo lesions progressed despite phototherapy.
After switching from upadacitinib to abrocitinib, the patient experienced marked repigmentation of vitiligo lesions within three months, along with continued control of AD symptoms.
This case highlights the differential effects of upadacitinib and abrocitinib, possibly due to their distinct JAK2 inhibition profiles. The findings underscore the importance of considering kinase selectivity when using JAK inhibitors in patients with overlapping immune-mediated skin disorders.
Janus激酶（JAK）抑制剂已成为特应性皮炎（AD）的靶向治疗药物，越来越多的证据表明其在白癜风治疗中具有潜在益处。虽然这两种疾病在免疫学上被认为是不同的，但最近的研究表明，它们的细胞因子途径存在重叠，可能受JAK1选择性抑制剂调节。
我们报告一例37岁男性患者，患有中度至重度AD和稳定期白癜风，在用乌帕替尼治疗后白癜风病情加重。尽管AD症状得到缓解，但白癜风皮损在光疗后仍有进展。
从乌帕替尼换用阿布昔替尼后，患者在三个月内白癜风皮损出现明显色素再生，同时AD症状持续得到控制。
该病例突出了乌帕替尼和阿布昔替尼的不同作用效果，可能是由于它们对JAK2的抑制作用不同。这些发现强调了在患有重叠性免疫介导性皮肤病的患者中使用JAK抑制剂时考虑激酶选择性的重要性。
