Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Meningiomas are common intracranial tumors; however, reports on extracranial cutaneous meningiomas are exceedingly rare. A 77-year-old woman visited our hospital with an asymptomatic child fist-sized mass on the scalp.Biopsy results indicated nuclear atypia and mitoses of sarcomatous cells. Brain magnetic resonance imaging revealed a subgaleal mass with strong enhancement. Suspecting sarcoma, wide excision was performed jointly by the departments of plastic surgery and neurosurgery, during which no evidence of cranial invasion was noted. In the surgical specimen, numerous mitoses of sarcomatous cells and poorly formed nests of epithelioid cells were observed. This led to the diagnosis of anaplastic meningioma without intracranial origin. Subsequently, the patient received adjuvant radiotherapy and is currently under close follow-up. Anaplastic meningioma is rare, but early diagnosis is important as it enables timely and appropriate treatment, thus, improving survival rates. Dermatologists should remain vigilant as meningiomas can manifest as cutaneous scalp nodules, and their accurate diagnosis can profoundly impact prognosis.

Acrodermatitis continua of Hallopeau (ACH) is a rare type of pustular psoriasis that causes periungual sterile pustules, paronychia, onychodystrophy, osteolysis, and atrophic skin. This condition is known for being resistant to conventional anti-psoriatic treatments. Therefore, biologics have been explored as potential management options for ACH. A 48-year-old male presented with erythematous swelling, pustular eruptions, desquamation, and nail dystrophy on his left third fingertip for a year. Despite various anti-psoriatic treatments, including 308 nm excimer laser, oral cyclosporine, acitretin, and methotrexate, the symptoms persisted. After 9 years of experiencing this condition, the patient was started on guselkumab (an interleukin-23 inhibitor), and showed significant improvement after eight injections. The patient was in good health without any adverse effects. This case report highlights the potential effectiveness of guselkumab in the treatment of refractory ACH.

A 54-year-old man presented to our outpatient clinic with generalized pruritic millet-sized vesicles, pustules, and crusts on the whole body over the past 10 years, which were more dominant in the lower extremities. Due to the difficulty in diagnosis, a series of histopathologic examinations were conducted during the treatment course, and the findings were similar: subcorneal pustules with neutrophils, superficial perivascular and dermal infiltration of lymphocytes, neutrophils, and eosinophils, with no sign of acantholysis. The patient was treated with cyclosporine, prednisolone, doxycycline, colchicine, sulfasalazine, and acitretin; however, his condition did not improve. After showing a dramatic improvement with dapsone, he was finally diagnosed with subcorneal pustular dermatosis (SPD).Various medications commonly used in inflammatory and immunobullous skin diseases were tried but failed to improve the condition; the patient showed a dramatic response only to dapsone. Due to its rarity, careful attention and repeated biopsies are required for diagnosing SPD.