Two cases of therapy-refractory chilblain lupus erythematosus successfully treated with deucravacitinib.

Chilblain lupus erythematosus is a rare skin manifestation of lupus erythematosus (LE), which has proven particularly difficult to treat and therefore often presents a great challenge for patients and physicians. We treated two patients with cases of long-lasting, refractory chilblain LE with the selective, allosteric TYK2-inhibitor deucravacitinib. Both patients showed rapid improvement of their respective skin lesions and symptoms. The treatment was generally well tolerated with no severe adverse events. One of the patients experienced an intermittent occurrence of acne lesions. We therefore suggest deucravacitinib as a promising and safe off-label treatment option for chilblain LE.