%0 Journal Article
%T Topical Ruxolitinib in the Treatment of Necrobiosis Lipoidica: A Prospective, Open-Label Study.
%A Hwang AS
%A Kechter JA
%A Li X
%A Hughes A
%A Severson KJ
%A Boudreaux B
%A Bhullar P
%A Nassir S
%A Yousif M
%A Zhang N
%A Butterfield RJ
%A Nelson S
%A Xing X
%A Tsoi LC
%A Zunich S
%A Sekulic A
%A Pittelkow M
%A Gudjonsson JE
%A Mangold A
%J J Invest Dermatol
%V 144
%N 9
%D 2024 Sep 27
%M 38417541
%F 7.59
%R 10.1016/j.jid.2023.11.027
%X Necrobiosis lipoidica (NL) is a rare granulomatous disease. There are few effective treatments for NL. We sought to investigate the efficacy and safety of the Jak1/2 inhibitor, ruxolitnib, in the treatment of NL and identify the biomarkers associated with the disease and treatment response. We conducted an open-label, phase 2 study of ruxolitinib in 12 patients with NL. We performed transcriptomic analysis of tissue samples before and after treatment. At week 12, the mean NL lesion score decreased by 58.2% (SD = 28.7%, P = .003). Transcriptomic analysis demonstrated enrichment of type I and type II IFN pathways in baseline disease. Weighted gene coexpression network analysis demonstrated post-treatment changes in IFN pathways with key hub genes IFNG and signal transducer and activator of transcription 1 gene STAT1. Limitations include small sample size and a study group limited to patients with <10% body surface area. In conclusion, ruxolitinib is an effective treatment for NL and targets the key pathogenic mediators of the disease.