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.

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.

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.

It is important to differentiate violaceous to dusky red papules and plaques that widely persist on the trunk and extremities because there are dermatoses that could be fatal, such as lupus erythematosus, dermatomyositis, drug eruptions, and graft-versus-host disease.Dyskeratotic cells only in the upper epidermis and horny layer are not well known, but it is a distinctive histopathological pattern of atypical type of rash of adult-onset Still’s disease (AOSD). AOSD rash is a transient salmon-colored rash that occurs and disappears with fever; however, an atypical type of rash called “persistent dermal plaque” or “persistent pruritic eruptions” has also been reported. It occurs and persists even after fever subsides.Herein, we describe a case with necrotic dyskeratotic cells in the upper epidermis and horny layer without AOSD symptoms lasting for five years.