JAK 1–3 & TYK2 Inhibitors in Dermatology
Del Rosso-Armstrong-Lebwohl-Brownstone
Quick Reference Chart
This table is not intended to replace medical judgment.
Generic Name (Brand Name) and MOA | FDA-Approved Indications (Approved Age) | Derm Dosing | Suggested Monitoring* | Clinical Considerations |
|---|---|---|---|---|
| Systemic | ||||
Upadacitinib (Rinvoq)† | Derm: Atopic dermatitis (≥12 yrs) Other: Ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, Crohn’s disease | 15 mg PO QD starting dose | Initial: TB, CBC w/diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/diff., CMP, lipids at 4-12 weeks and repeat annually, TB annually | • Approved for adolescents ≥12 years and weighing at least 40 kg |
Abrocitinib (Cibinqo)† | Derm: Atopic dermatitis (≥12 yrs) Other: None | 100 mg PO QD starting dose | Initial: TB, CBC w/diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/diff., CMP, lipids at 4-12 weeks and repeat annually, TB annually | • Moderate renal impairment: 50 mg PO QD or 100 mg PO QD for patients who are not responding to 50 mg |
Baricitinib (Olumiant)† | Derm: Severe alopecia areata (≥18 yrs) Other: Rheumatoid arthritis, COVID-19 in hospitalized adults | 2 mg QD, consider increase to 4 mg QD if inadequate response | Initial: TB, CBC w/diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/diff., CMP, lipids at 4-12 weeks and repeat annually, TB annually | • Not recommended in patients with severe renal impairment |
Ritlecitinib (Litfulo)† | Derm: Severe alopecia areata (≥12 yrs) Other: None | 50 mg PO QD | Initial: TB, CBC w/diff., CMP, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/diff., CMP at 4-12 weeks and repeat annually, TB annually | • Efficacy and AE profiles similar between adolescent and adults |
Tofacitinib (Xeljanz)† | Derm: Psoriatic arthritis (≥18 yrs) Other: Rheumatoid arthritis, ankylosing spondylitis, ulcerative colitis, polyarticular course juvenile idiopathic arthritis | 5 mg PO BID (PsA dose) | Initial: TB, CBC w/diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: TB annually, CBC w/diff. at 4-8 weeks then q 3 months, LFTs at q 3-6 months, lipids at 4-8 weeks and repeat annually | • Consider QD dosing in moderate/severe renal impairment or moderate hepatic impairment |
Deuruxolitinib (Leqselvi)† | Derm: Severe alopecia areata (≥18 yrs) Other: None | 8 mg PO BID | Initial: CYP2C9 genotype test, TB, CBC w/ diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/ diff., CMP, lipids at 4-12 weeks, TB annually | • No dose adjustment is recommended for patients with moderate renal impairment or mild-moderate hepatic impairment |
Deucravacitinib (Sotyktu) | Derm: Psoriasis (≥18 yrs) Other: None | 6 mg PO QD | Initial: LFTs and viral hepatitis screening in patients with known or suspected liver disease, TB, pregnancy, HIV, vaccinations Follow up: LFTs in patients with known or suspected liver disease at ~3 months | • No boxed warning |
| Topical | ||||
Ruxolitinib (Opzelura)† | Derm: Atopic dermatitis (≥12 yrs), vitiligo (≥12 yrs) Other: None | Apply 1.5% cream BID | No routine lab monitoring required | • For atopic dermatitis, can treat up to 20% BSA; for vitiligo, up to 10% BSA (per PI) |
Delgocitinib cream 2% (Anzupgo) | Derm: Chronic hand eczema (≥18 yrs) Other: None | Apply BID to skin of affected areas only on the hands and wrist, not exceeding 30 g per 2 weeks or 60 g per month | No routine lab monitoring required | • No boxed warning |
AE = Adverse event; ALC = Absolute lymphocyte count; ANC = Absolute neutrophil count; BID = Twice daily; BSA = Body surface area; CBC = Complete blood count; CMP = Comprehensive metabolic panel; ESRD = End-stage renal disease; Hgb = Hemoglobin; HIV = Human immunodeficiency virus; JAK = Janus kinase; LFT = Liver function test; Mg = Milligrams; MOA = Mechanism of action; PI = Prescribing information; PLT = Platelets; PO = By mouth; PsA = Psoriatic arthritis; QD=once daily; TB = Tuberculosis; TYK2 = Tyrosine kinase 2
*As evidence is not sufficient to fully assess the safety of JAK inhibitors in pregnancy and lactation, it is not recommended for use in women who are pregnant or nursing; vaccinations should be done before starting a JAK inhibitor; perform pre-treatment HIV testing in high-risk populations. Specifically check ALC, ANC, PLT and Hgb at initiation and subsequent monitoring as per individual PIs.
†Boxed Warning: serious infections, mortality, malignancy, major adverse cardiovascular events, and thrombosis. See full PI for additional information.
v3 - August 12, 2025. © 2025 - April W. Armstrong, MD, MPH, James Q. Del Rosso, DO, Mark Lebwohl, MD, and Nicholas Brownstone, MD.
DISCLAIMER: The dosages and other information seen in this chart were primarily obtained from the respective FDA-approved package inserts. This chart is for reference only and not to be substituted for clinical judgment. The authors are not responsible for treatment decisions or outcomes based on the information in this chart. Please check for drug interactions.