Derm Outcomes

Pemphigus vulgaris (PV) is a severe autoimmune blistering disorder that often starts with painful mucosal erosions and can progress to widespread skin involvement. Standard treatments typically include corticosteroids, rituximab, and steroid-sparing agents, but some patients remain refractory despite aggressive therapy 💊. In this case report by Dr. Saakshi Khattri at the Icahn School of Medicine, upadacitinib, a selective JAK1 inhibitor, was successfully used to achieve remission in a patient with persistent mucosal PV.

🧵https://bit.ly/3ztQ8cz

This 64-year-old patient had failed multiple therapies — including rituximab, IVIG, mycophenolate, and high-dose corticosteroids — yet continued to suffer from painful oral lesions and poor quality of life 🥄. After starting off-label upadacitinib 15 mg daily alongside IVIG and rituximab, the patient's mucosal lesions steadily healed, PO intake improved, and no new lesions developed ✨. After 6 months of therapy, the patient achieved corticosteroid-free remission with no new cutaneous or mucosal lesions 🎯.

This case is important because JAK-STAT signaling is implicated in PV pathogenesis via aberrant Th1/Th2 cytokine activity (including IFN-γ, IL-4, IL-6, IL-10, IL-15) which drive B-cell activation and autoantibody production 🧬. By targeting this pathway, upadacitinib may help break the cycle of inflammation and tissue injury in PV 🔄.

While randomized data are still needed, this report suggests JAK inhibitors could represent a promising adjunct in refractory PV, particularly for difficult-to-treat mucosal involvement where conventional options may fall short 🌟.

Icahn School of Medicine at Mount Sinai
The Mount Sinai Hospital

Call for abstracts! 📝 We are accepting abstract applications for our upcoming annual meeting. Abstracts concerning outcomes in the following categories may be submitted: Actinic Keratosis, Acne, Cutaneous T-Cell Lymphoma, Hidradenitis Suppurativa, Itch, Psoriasis, Psoriatic Arthritis, Vitiligo, and other areas in dermatology.

Stakeholders, trainees, and industry representatives at any level are eligible to submit an abstract.

The submission deadline is Friday, April 18th.

Please find the rules & guidelines, FAQs, and submission details here: https://form.jotform.com/ideom/2025-abstract-application

There are not many studies that directly compare the effectiveness of different biological drugs over long observation periods. With many treatment guidelines being formulated based on drug class, there is a greater need to compare drug classes rather than specific biologic agents.

IDEOM Hidradenitis Suppurativa Subcommittee Chair Dr. Saakshi Khattri recently led a study which directly compared the effectiveness of biologic classes in clinical practice. In this 12-month post-hoc analysis, researchers compared the efficacy and durability of biologics targeting the interleukin (IL)-17 A ligands or the IL-17 receptor A (IL-17RA) against other approved drug classes with plaque psoriasis.

Their findings showed that anti-IL-17A/RA had the highest effectiveness of achieving early response to treatment and maintaining that response through 12 months, as opposed to other drug classes.

To read the full article, please visit: https://pmc.ncbi.nlm.nih.gov/articles/PMC11782404/

Comparative Effectiveness of Biologic Classes in Clinical Practice: Month 12 Outcomes from the International Observational Psoriasis Study of Health Outcomes (PSoHO) Studies directly comparing the effectiveness of different biologics over long observation periods are lacking. As many treatment guidelines are formulated based on drug class, there is a particular need to compare drug classes rather than specific ...