Adolescent with severe atopic dermatitis and comorbid joit disease: remission achievement by selective JAK1-inhibitor treatment

Abstract

Atopic dermatitis is a heterogenous in terms of inflammatory pathways and severity prognosis skin disease. The typical clinical manifestations of the disease are intense itching and eczematisation of the skin. The prevalence of atopic dermatitis is markedly higher in children than in adult patients. Persistence of clinical manifestations and recurrent exacerbations of the disease in adolescents can determine the prognosis for decades of working age, leading to a decrease in the quality of life, socialisation and educational success. Some patients demonstrate severe recurrent course of the disease which do not respond on standard topical anti-inflammatory preparations. Comorbid diseases (not only atopic ones) could serve additional factors complicating atopic dermatitis control achievement. The adolescent patient (well-known for low adherence to topical treatment) could become a special difficulty in clinical management. A clinical case of successful systemic therapy (upadacitinib 15 mg once daily) of severe atopic dermatitis patient comorbid with immunologically-driven joint disease presented. Previous topical treatment of atopic dermatitis was inefficient. Effectiveness (indexes SCORAD and DLQI, digital itch scale) and safety (laboratory data and complains) were evaluated for more than 1 year (15 months) of therapy. Rapid and sustain positive changes in course control of atopic dermatitis with possible T2-associated and other inflammatory mediators were demonstrated.