Tofacitinib is a Janus kinase inhibitor that was approved for the treatment of rheumatoid arthritis. Other indications pending clinical trials and observational reports such as alopecia areata vitiligo and atopic dermatitis are under evaluation (1–4). For the past four years, we treated a 30-year-old female with pain and swelling of her hands and knees, her synovial fluid analysis showed inflammatory fluid, and the diagnosis of sero negative rheumatoid arthritis was performed. In an attempt to improve arthritis, an orthopedic procedure was performed and synovial biopsy obtained showed chronic non-specific synovial inflammation. The patient also complained from vitiligo that antecedes arthritis for a few years. She started Tofacitinib 5 mg twice a day and marked improvement was observed on both diseases with significant reduction in pain swelling and almost no complain of arthritis; her vitiligo lesions improved as well, becoming almost fully regimented after 4 months of continuous therapy. Figures 1 and 2 show outcome of arthritis and skin disease. Consent information was provided by the patient.
Figure 1. a, b.
The disappearance of synovial thickening is appreciated on magnetic resonance imaging (a). Synovial thickening disappeared after therapy (b).
Figure 2. a, b.
Resolution of hypopigmented lesions before (a) and after therapies (b).
Footnotes
Informed Consent: Informed consent was obtained from the patient.
Peer-review: Externally peer-reviewed.
Author Contributions: Concept - M.S.; Writing Manuscript - M.S., S.B.F., D.C.B.; Critical Review - S.B.F., D.C.B.
Conflict of Interest: The authors have no conflict of interest to declare.
Financial Disclosure: The authors declared that this study has received no financial support.
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