Successful treatment of atopic dermatitis with the JAK1 inhibitor oclacitinib.

We report the first case of atopic dermatitis successfully treated with the oral Janus kinase-1 (JAK1) inhibitor oclacitinib. A man in his 70s, with a 6-year history of skin disease refractory to topical and biologic therapies, self-prescribed this veterinary medication with rapid remission of symptoms. He has remained in remission for 7 months with no reported adverse side effects or infections. JAK1 plays a central role in expression of proinflammatory cytokines IL-4, IL-5, and IL-13, which play an important role in the pathogenesis of atopic dermatitis. Ruxolitinib and tofacitinib are JAK inhibitors currently approved by the Food and Drug Administration for the treatment of myelofibrosis, rheumatoid arthritis, and psoriatic arthritis in humans. Oclacitinib is not currently indicated for use in humans.