Clinical Scorecard: Clinical Observation: Significant Recovery with Upadacitinib in a Patient Exhibiting Paradoxical Skin Lesions Linked to SAPHO Syndrome
At a Glance
Category
Detail
Condition
Key Mechanisms
Involvement of proinflammatory cytokines TNF-α and IL-17; JAK/STAT signaling pathway.
Target Population
Care Setting
Key Highlights
Patient experienced paradoxical skin lesions after TNF-α inhibitor treatment.
Initial treatment with etoricoxib and methotrexate improved musculoskeletal symptoms but not skin lesions.
Switching to upadacitinib resulted in rapid improvement of skin lesions and sustained control of musculoskeletal symptoms.
No adverse events were reported during upadacitinib therapy.
Guideline-Based Recommendations
Diagnosis
Diagnosis based on clinical manifestations and imaging findings.
Management
Consider JAK inhibitors for patients with paradoxical skin lesions induced by TNF-α inhibitors.
Monitoring & Follow-up
Monitor liver and kidney function during treatment.
Risks
Potential for paradoxical skin lesions with TNF-α inhibitors.
Patient & Prescribing Data
42-year-old male with a 6-year history of SAPHO syndrome.
Upadacitinib (15 mg once daily) led to significant improvement in skin lesions.
