Janus kinase inhibitors in the management of lichen planus: a systematic review.

BACKGROUND AND

OBJECTIVES

Lichen planus (LP) is a chronic, lymphocytic, inflammatory skin disorder that can affect the skin, hair follicles, nails, and mucous membranes. It has limited treatment options. The pathogenesis of LP includes inflammation driven by interferons and the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway. Thus, Janus kinase inhibitors (JAKi) have been proposed as a viable therapeutic approach for LP. JAKi have recently been approved to treat some lymphocytic skin disorders such as alopecia areata and atopic dermatitis. The purpose of the systematic review was to assess the effects of JAKi on LP.

MATERIALS AND

METHODS

We searched PubMed, Scopus, and Google Scholar and included all studies published between January 2015 and May 2024 that assess the clinical effects of JAKi on lichen planus, including cutaneous and mucosal/adnexal variants. The risk of bias in included studies was assessed using Joanna Briggs Institute (JBI) tools, classifying bias as low, moderate and high concerns.

RESULTS

A total of 57 full-text publications were evaluated, of which 34 papers were excluded because they did not match the criteria. Therefore, this systematic review included 23 papers, seven of them were case series and the remaining 16 were case reports. There were 13 papers on tofacitinib, six on baricitinib, and two papers each on ruxolitinib and upadacitinib.

CONCLUSION

Several case series and case reports have shown beneficial effects of JAK inhibitors to treat LP. Few patients had minor adverse events.