CASE REPORT article
Front. Med.
Sec. Dermatology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1651033
This article is part of the Research TopicType 2 Inflammatory Skin Diseases: Novel Therapies and Clinical InsightsView all articles
A Case of Eruptive Pruritic Papular Porokeratosis with Atopic Dermatitis Treated with Upadacitinib: A Novel Therapeutic Perspective
Provisionally accepted
- 1Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- 2Chengdu University of Traditional Chinese Medicine, Chengdu, China
- 3Department of Dermatology, The First Affiliated Hospital of Chongqing College of Traditional Chinese Medicine, Chongqing, China
- 4Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
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Eruptive pruritic papular porokeratosis is a rare subtype of porokeratosis, characterized by the appearance of intensely pruritic erythematous papules. Conventional therapies-including antihistamines, corticosteroids, and retinoids-often yield limited clinical benefit. This case report describes a 73-year-old Chinese man diagnosed with eruptive pruritic papular porokeratosis coexisting with moderate-to-severe atopic dermatitis.The patient developed widespread erythematous papules involving the scalp, trunk, and extremities, accompanied by severe pruritus and exudation secondary to scratching. Despite prior treatment with tofacitinib, acitretin, tripterygium glycosides, and antihistamines (epinastine and olopatadine), the patient exhibited a suboptimal clinical response.Consequently, treatment with upadacitinib, a selective Janus kinase 1 inhibitor, was initiated. Within one week, pruritus markedly improved, and the papules began to flatten.After one month of therapy, pruritus had nearly resolved, and the skin lesions showed progressive regression. The patient continued on a reduced dose of upadacitinib, without evidence of relapse or treatment-related adverse events during follow-up. This case highlights the potential of upadacitinib as an effective and well-tolerated therapeutic option for eruptive pruritic papular porokeratosis with concurrent atopic dermatitis, particularly in refractory cases. Further studies are warranted to evaluate its long-term efficacy and safety.
Keywords: Upadacitinib, Eruptive pruritic papular porokeratosis, Janus kinase inhibitors, atopic dermatitis, Porokeratosis
Received: 20 Jun 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Hu, Xiao, Zhao and Lou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fanglu Lou, Department of Dermatology, The First Affiliated Hospital of Chongqing College of Traditional Chinese Medicine, Chongqing, China
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