Palmoplantar Pustulosis-like Eruption Induced by Baricitinib for Treatment of Rheumatoid Arthritis

Dimitra Koumaki; Vasiliki Koumaki; Eleni Lagoudaki; George Bertsias

doi:10.12890/2019_001383

Palmoplantar Pustulosis-like Eruption Induced by Baricitinib for Treatment of Rheumatoid Arthritis

Eur J Case Rep Intern Med. 2019 Dec 19;7(1):001383. doi: 10.12890/2019_001383. eCollection 2020.

Authors

Dimitra Koumaki¹, Vasiliki Koumaki², Eleni Lagoudaki³, George Bertsias⁴

Affiliations

¹ Dermatology Department, University Hospital of Heraklion, Crete, Greece.
² Microbiology Department, Medical School of Athens, Athens, Greece.
³ Pathology Department, University Hospital of Heraklion, Crete, Greece.
⁴ Rheumatology Department, University Hospital of Heraklion, Crete, Greece.

Abstract

Objectives: Baricitinib is an orally active Janus kinase (JAK) inhibitor used in the treatment of moderate to severe rheumatoid arthritis (RA).

Materials and methods: Here, we report the case of a 56-year-old Caucasian male diagnosed with RA who developed palmoplantar pustulosis (PPP) while being treated with baricitinib.

Results: The patient's PPP resolved after discontinuation of baricitinib and recurred when this was restarted. Based on causality assessment, it was considered a drug-induced PPP.

Conclusion: To the authors' knowledge, this is the first case of baricitinib-induced PPP.

Learning points: Baricitinib is a small, orally active molecule that inhibits JAK-1 and JAK-2, which is used in the treatment of rheumatoid arthritis.Baricitinib has been also used in the treatment of psoriasis, alopecia areata and atopic dermatitis.Palmoplantar pustulosis is a rare cutaneous side effect of baricitinib.

Keywords: Palmoplantar pustulosis; baricitinib; cutaneous side effects; rheumatoid arthritis.