Successful Treatment of Refractory Livedoid Vasculopathy with Upadacitinib: A Case Report.

Purpose: While tofacitinib, baricitinib, and abrocitinib demonstrate efficacy in livedoid vasculopathy (LV), this study evaluates upadacitinib-a distinct Janus kinase (JAK) inhibitor-in refractory LV. Patients and Methods: A 54-year-old female with treatment-resistant LV received upadacitinib (15 mg/day). Treatment response was assessed via composite clinical scores pre- and post-therapy. Results: Significant improvement occurred within 24 days (score: 7→2), indicating remission. Pain intensity markedly decreased, and near-complete ulcer healing was observed by day 52. No adverse effects were observed, with the exception of orolabial herpes simplex. Conclusion: Upadacitinib represents a novel therapeutic alternative for LV. Larger cohorts are needed to validate these findings.