Remission of necrobiosis lipoidica diabeticorum with a JAK1/2 inhibitor: A case report

Barbet-Massin, Marie-Amélie; Rigalleau, Vincent; Blanco, Patrick; Mohammedi, Kamel; Poupon, Pauline; Belin, Eric; Poursac, Nicolas; Cadart, Olivier; Blanco, Laurence

doi:10.1016/j.diabet.2020.01.001

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…Other treatment options include PUVA, photodynamic therapy, immunomodulators (Methotrexate, Mycophenolate mofetil), antimalarials (hydroxychloroquine and chloroquine), fumaric acid esters, cutaneous blood flow modulators (aspirin, dipyridamole, pentoxifylline, ticlopidine), biologics (anti-TNF alpha, Ustekinumab), cyclosporine, topical tretinoin, thalidomide, and surgery with excision followed by skin grafting [25,[107][108][109][110][111][112][113][114][115][116][117]. Several recent case reports have proven the efficacy of Janus kinase inhibitors (JAK) such as ruxolitinib, baricitinib, and tofacitinib [118][119][120][121][122]. JAKs have proven to be effective in the treatment of inflammatory diseases.…”

Section: Therapeutic Barriersmentioning

confidence: 99%

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The Intersection of Dermatological Dilemmas and Endocrinological Complexities: Understanding Necrobiosis Lipoidica—A Comprehensive Review

Ionescu,

Petca,

Dumitrașcu

et al. 2024

Biomedicines

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Background: Necrobiosis lipoidica (NL) is a rare granulomatous skin disorder with a predilection for females, often associated with diabetes mellitus (DM). This paper aims to comprehensively review the literature on NL, focusing on its association with DM, thyroid disorders, and the metabolic syndrome. Methods: A systematic search was conducted in English-language literature from inception to October 2023, utilizing PubMed. We identified 530 studies and selected 19 based on clinical significance, statistical support, and relevance to the paper’s goals. Results: The coexistence of NL and DM is prevalent, with rates ranging from 11% to 65.71%. NL may precede DM diagnosis and a correlation between NL and increased daily insulin requirements has been observed in such patients. NL is suggested as a potential prognostic marker for DM complications; however, recent studies question this association, highlighting the need for further research. Studies in the context of NL and Thyroid Disease indicate a correlation, especially with autoimmune thyroiditis. Regarding NL and Metabolic Syndrome, the prevalence of metabolic syndrome among NL patients is notably higher than in the general population. Additionally, DM patients with ulcerated NL commonly exhibit hypertension or obesity, raising questions about the potential influence of hypertension and obesity on NL ulcerations. Conclusion: Additional research is required to untangle the complex connections between NL and various comorbidities.

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Section: Therapeutic Barriersmentioning

confidence: 99%

“…These molecules inhibit the activity of the JAK family of enzymes' activity, which are tyrosine kinase enzymes responsible for transmitting signals from surface receptors to the nucleus. JAKs regulate more than 50 cytokines and growth factors [121].…”

Section: Therapeutic Barriersmentioning

confidence: 99%

The Intersection of Dermatological Dilemmas and Endocrinological Complexities: Understanding Necrobiosis Lipoidica—A Comprehensive Review

Ionescu,

Petca,

Dumitrașcu

et al. 2024

Biomedicines

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“…During therapy, she developed rheumatoid arthritis (RA) with rheumatoid nodules on both hands, so baricitinib 4 mg daily was included. After 6 months, remission was achieved in not only in RA but also in NL [ 100 ].…”

Section: Treatment Standards and New Therapeutic Optionsmentioning

confidence: 99%

A Breakthrough in the Treatment of Necrobiosis Lipoidica? Update on Treatment, Etiopathogenesis, Diagnosis, and Clinical Presentation

Naumowicz,

Modzelewski,

Macko

et al. 2024

IJMS

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Necrobiosis lipoidica (NL) is a rare granulomatous disease of a not fully understood etiopathogenesis. Classically, NL is associated with insulin-dependent diabetes mellitus. The disease often fails to respond to conventional treatments and adversely affects patients’ quality of life. First-line medications are usually topical corticosteroids, but patients respond to them with varying degrees of success. Other options include tacrolimus, phototherapy, cyclosporine, fumaric acid esters, and biologics (adalimumab, etanercept, and infliximab). Our review aims to present new therapeutic approaches potentially effective in patients with refractory lesions, describe the presumed etiopathogenesis, and provide diagnostic guidance for clinicians. The review concludes that Janus kinase inhibitors and biologics such as ustekinumab and secukinumab can be used effectively in patients with recalcitrant NL. Another promising treatment option is tapinarof (an aryl hydrocarbon receptor agonist). However, studies on larger groups of patients are still needed to evaluate the effectiveness of different therapeutic options and to define consistent treatment regimens for NL. It is advisable to improve the awareness of physicians of various specialties regarding necrobiosis lipoidica as lesions diagnosed earlier usually have a better response to treatment.

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“…Several case reports of Jak inhibition in NL have also been published. Five patients with ulcerative NL and one patient with nonulcerative NL have been treated with oral Jak inhibitors, including tofacitinib (Jak1/3>2) (n = 4), ruxolitinib (Jak1/2) (n = 1), and baricitinib (Jak1/2) (n = 1) ( Barbet-Massin et al., 2021 ; Damsky et al., 2020c ; Erfurt-Berge and Sticherling, 2020 ; Janßen and Jansen, 2022 ; Lee and English, 2018 ; McPhie et al., 2021 ). All five of the patients with ulcerative NL experienced closure of their ulcerations and improvement in inflammation, and the patient with nonulcerative NL experienced complete remission.…”

Section: Nlmentioning

confidence: 99%

Molecularly Targeted Therapies for Inflammatory Cutaneous Granulomatous Disorders: A Review of the Evidence and Implications for Understanding Disease Pathogenesis

Hwang,

Abdelghaffar,

Shields

et al. 2023

JID Innovations

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Remission of necrobiosis lipoidica diabeticorum with a JAK1/2 inhibitor: A case report

Cited by 6 publications

References 5 publications

The Intersection of Dermatological Dilemmas and Endocrinological Complexities: Understanding Necrobiosis Lipoidica—A Comprehensive Review

The Intersection of Dermatological Dilemmas and Endocrinological Complexities: Understanding Necrobiosis Lipoidica—A Comprehensive Review

A Breakthrough in the Treatment of Necrobiosis Lipoidica? Update on Treatment, Etiopathogenesis, Diagnosis, and Clinical Presentation

Molecularly Targeted Therapies for Inflammatory Cutaneous Granulomatous Disorders: A Review of the Evidence and Implications for Understanding Disease Pathogenesis

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