Effectiveness of Abrocitinib in Atopic Dermatitis Presenting with Hand-Foot Eczema and Nail Dystrophy: A Case Report.

Eczema-associated nail dystrophy is an uncommon but clinically relevant manifestation of atopic dermatitis (AD), which can lead to substantial structural and functional impairment and impose significant therapeutic challenges. However, evidence regarding systemic treatment for AD-related nail involvement remains limited. We report a case of AD presenting predominantly with refractory hand and foot eczema and marked nail dystrophy who achieved notable improvement following treatment with the selective Janus kinase 1 (JAK1) inhibitor abrocitinib, with cutaneous symptoms improving within several weeks after dose escalation and both fingernail and toenail abnormalities showing gradual structural recovery over a 12-month follow-up. Furthermore, the treatment was well tolerated throughout the follow-up period. This case suggests that abrocitinib may represent a promising therapeutic option for eczema-associated nail changes in patients with AD.