• Teresa Grieco, Martina Caviglia, Giuseppina Cusano, Alvise Sernicola, Camilla Chello, Ester Del Duca, Carmen Cantisani, Alberto Taliano, Nicolò Sini, Gianluca Ianiro, and Giovanni Pellacani.
• Dermatology Unit, Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, 00161 Rome, Italy.
• Medicina (Kaunas). 2023 Mar 10; 59 (3).

AbstractBackground and Objectives: JAK inhibitors entered current clinical practice as treatment for several immune-related diseases and, recently, for atopic dermatitis. These drugs target the Janus Kinase intracellular cascade, rendering them suitable for treating both Th1 and Th2 immune-mediated responses. Materials and Methods: We report the case of a 36-year-old male patient presenting an overlap of ulcerative colitis, a Th1-related disease, and atopic dermatitis, a Th2-mediated condition. Treatment with upadacitinib was initiated, and laboratory and instrumental follow-ups were carried out for 8 months. Results: The complete and persistent clinical remission of both conditions was observed at a low dose of 15 mg of upadacitinib, even though ulcerative colitis guidelines usually recommend a dosage of 45 mg. No serious adverse responses to therapy were reported. Conclusions: Upadacitinib may be the most suitable management strategy in subjects with coexisting severe conditions mediated by Th1 inflammation, such as ulcerative colitis, and by Th2 cytokines, such as atopic dermatitis.

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