Unveiling a Therapeutic Breakthrough: Baricitinib in the Treatment of Acute and Recurrent Pustulosis Associated with Atopic Dermatitis—A Case Report, Literature Review, and Novel Clinical Insights
Acute and recurrent pustulosis (ARP), previously known as actinic folliculitis, superficial actinic folliculitis, or even acne aestivalis, is a rare, underdiagnosed dermatological condition characterized by the sudden onset of monomorphic pustular eruptions on an erythematous background localized pr...
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2025-03-01
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| author | Daciana Elena Brănișteanu Cătălina Anca Munteanu Daniel Constantin Brănișteanu Cristina Colac-Boțoc Roxana Paraschiva Ciobanu Antonia Elena Huțanu Cătălina Onu-Brănișteanu Gabriela Stoleriu Laura Endres Cojocaru Elena Stefan Vasile Toader |
| author_facet | Daciana Elena Brănișteanu Cătălina Anca Munteanu Daniel Constantin Brănișteanu Cristina Colac-Boțoc Roxana Paraschiva Ciobanu Antonia Elena Huțanu Cătălina Onu-Brănișteanu Gabriela Stoleriu Laura Endres Cojocaru Elena Stefan Vasile Toader |
| author_sort | Daciana Elena Brănișteanu |
| collection | DOAJ |
| description | Acute and recurrent pustulosis (ARP), previously known as actinic folliculitis, superficial actinic folliculitis, or even acne aestivalis, is a rare, underdiagnosed dermatological condition characterized by the sudden onset of monomorphic pustular eruptions on an erythematous background localized predominantly on the upper body. While typically associated with sun exposure, ARP can also be triggered by other factors, such as heat or sweating, underscoring its multifactorial etiology. We report the case of a 40-year-old woman with ARP, presenting diagnostic challenges due to overlapping clinical features and the coexistence of atopic dermatitis (AD), an association not previously documented in the literature. The patient exhibited recurrent pustular episodes localized on sun-exposed and non-exposed areas, unresponsive to conventional therapies. Comprehensive microbiological, histopathological, and clinical assessments excluded infectious, drug-induced, and other inflammatory pustular dermatoses, confirming the diagnosis of ARP. Importantly, treatment with Baricitinib, a Janus kinase (JAK) inhibitor primarily prescribed for AD, resulted in marked improvement in both conditions, suggesting shared inflammatory pathways. This therapeutic response highlights the potential role of JAK inhibitors in ARP management, particularly in cases resistant to standard interventions. This report also proposes the inclusion of heat- and sweat-induced ARP as a distinct subtype, expanding the understanding of its diverse triggers beyond UV radiation. Furthermore, it underscores the need for standardized diagnostic criteria and a structured approach to differential diagnosis, given the condition’s underdiagnosed and often misinterpreted nature. By shedding light on the clinical and therapeutic aspects of ARP, this case contributes to a more nuanced understanding of this rare entity and its potential interplay with inflammatory skin disorders such as AD. |
| format | Article |
| id | doaj-art-d971c102f33e483086415f045645bcde |
| institution | DOAJ |
| issn | 2075-1729 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj-art-d971c102f33e483086415f045645bcde2025-08-20T03:13:52ZengMDPI AGLife2075-17292025-03-0115450710.3390/life15040507Unveiling a Therapeutic Breakthrough: Baricitinib in the Treatment of Acute and Recurrent Pustulosis Associated with Atopic Dermatitis—A Case Report, Literature Review, and Novel Clinical InsightsDaciana Elena Brănișteanu0Cătălina Anca Munteanu1Daniel Constantin Brănișteanu2Cristina Colac-Boțoc3Roxana Paraschiva Ciobanu4Antonia Elena Huțanu5Cătălina Onu-Brănișteanu6Gabriela Stoleriu7Laura Endres8Cojocaru Elena9Stefan Vasile Toader10Discipline of Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, RomaniaDermatology Clinic, University Clinical Railways Hospital, 1 Garabet Ibraileanu Str., 700115 Iasi, RomaniaDiscipline of Ophtalmology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, RomaniaDermatology Clinic, University Clinical Railways Hospital, 1 Garabet Ibraileanu Str., 700115 Iasi, RomaniaDermatology Clinic, University Clinical Railways Hospital, 1 Garabet Ibraileanu Str., 700115 Iasi, RomaniaDermatology Clinic, University Clinical Railways Hospital, 1 Garabet Ibraileanu Str., 700115 Iasi, RomaniaDepartment of Vascular Surgery, St. Pantelimon Hospital, Pantelimon Str., 021659 Bucharest, RomaniaFaculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University of Galați, 800008 Galați, RomaniaDepartment of Psycho-Neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, RomaniaDepartment of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, RomaniaDiscipline of Physiopathology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, RomaniaAcute and recurrent pustulosis (ARP), previously known as actinic folliculitis, superficial actinic folliculitis, or even acne aestivalis, is a rare, underdiagnosed dermatological condition characterized by the sudden onset of monomorphic pustular eruptions on an erythematous background localized predominantly on the upper body. While typically associated with sun exposure, ARP can also be triggered by other factors, such as heat or sweating, underscoring its multifactorial etiology. We report the case of a 40-year-old woman with ARP, presenting diagnostic challenges due to overlapping clinical features and the coexistence of atopic dermatitis (AD), an association not previously documented in the literature. The patient exhibited recurrent pustular episodes localized on sun-exposed and non-exposed areas, unresponsive to conventional therapies. Comprehensive microbiological, histopathological, and clinical assessments excluded infectious, drug-induced, and other inflammatory pustular dermatoses, confirming the diagnosis of ARP. Importantly, treatment with Baricitinib, a Janus kinase (JAK) inhibitor primarily prescribed for AD, resulted in marked improvement in both conditions, suggesting shared inflammatory pathways. This therapeutic response highlights the potential role of JAK inhibitors in ARP management, particularly in cases resistant to standard interventions. This report also proposes the inclusion of heat- and sweat-induced ARP as a distinct subtype, expanding the understanding of its diverse triggers beyond UV radiation. Furthermore, it underscores the need for standardized diagnostic criteria and a structured approach to differential diagnosis, given the condition’s underdiagnosed and often misinterpreted nature. By shedding light on the clinical and therapeutic aspects of ARP, this case contributes to a more nuanced understanding of this rare entity and its potential interplay with inflammatory skin disorders such as AD.https://www.mdpi.com/2075-1729/15/4/507non-microbial pustulesmonomorphic pustulesatopic dermatitisJAK inhibitorssun exposureskin biopsy |
| spellingShingle | Daciana Elena Brănișteanu Cătălina Anca Munteanu Daniel Constantin Brănișteanu Cristina Colac-Boțoc Roxana Paraschiva Ciobanu Antonia Elena Huțanu Cătălina Onu-Brănișteanu Gabriela Stoleriu Laura Endres Cojocaru Elena Stefan Vasile Toader Unveiling a Therapeutic Breakthrough: Baricitinib in the Treatment of Acute and Recurrent Pustulosis Associated with Atopic Dermatitis—A Case Report, Literature Review, and Novel Clinical Insights Life non-microbial pustules monomorphic pustules atopic dermatitis JAK inhibitors sun exposure skin biopsy |
| title | Unveiling a Therapeutic Breakthrough: Baricitinib in the Treatment of Acute and Recurrent Pustulosis Associated with Atopic Dermatitis—A Case Report, Literature Review, and Novel Clinical Insights |
| title_full | Unveiling a Therapeutic Breakthrough: Baricitinib in the Treatment of Acute and Recurrent Pustulosis Associated with Atopic Dermatitis—A Case Report, Literature Review, and Novel Clinical Insights |
| title_fullStr | Unveiling a Therapeutic Breakthrough: Baricitinib in the Treatment of Acute and Recurrent Pustulosis Associated with Atopic Dermatitis—A Case Report, Literature Review, and Novel Clinical Insights |
| title_full_unstemmed | Unveiling a Therapeutic Breakthrough: Baricitinib in the Treatment of Acute and Recurrent Pustulosis Associated with Atopic Dermatitis—A Case Report, Literature Review, and Novel Clinical Insights |
| title_short | Unveiling a Therapeutic Breakthrough: Baricitinib in the Treatment of Acute and Recurrent Pustulosis Associated with Atopic Dermatitis—A Case Report, Literature Review, and Novel Clinical Insights |
| title_sort | unveiling a therapeutic breakthrough baricitinib in the treatment of acute and recurrent pustulosis associated with atopic dermatitis a case report literature review and novel clinical insights |
| topic | non-microbial pustules monomorphic pustules atopic dermatitis JAK inhibitors sun exposure skin biopsy |
| url | https://www.mdpi.com/2075-1729/15/4/507 |
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