JAK Inhibitors as Potential Therapeutic Strategy for the Dilemma of Psoriasis Concurrent with Dermatomyositis in the SARS-CoV-2 Era

Qiannan Xu, Nan Xu Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Nan Xu, Tel +86 38804518, Email xnhrb@sina.comAbstract: Dermatomyositis is a rare inflammatory disease with potentially life-threatening systemic involvement that is treated with systemic corticosteroids. However, when psoriasis coexists with dermatomyositis, the administration of corticosteroids may exacerbate psoriasis after withdrawal, posing a treatment dilemma. Our search of the literature revealed 14 cases where various treatments were used, including methotrexate, corticosteroids, cyclosporin, ustekinumab, mycophenolate mofetil, and azathioprine. While methotrexate showed promise, it carries risks, and corticosteroids were used despite their potential to exacerbate psoriasis. Based on transcriptomic data analysis of psoriasis and dermatomyositis, the type II interferon-mediated signaling pathway was enriched in both diseases. Medication targeting this pathway, such as JAK inhibitors, could be a potential solution for the psoriasis concurrent with dermatomyositis dilemma, as JAK inhibitors have been proven effective in treating both dermatomyositis and psoriasis, with some being FDA-approved for treating COVID-19. Therefore, JAK inhibitors may be a potential therapeutic strategy for psoriasis concurrent with dermatomyositis in the SARS-CoV-2 era.Keywords: psoriasis, dermatomyositis, treatment, JAK, SARS-CoV-2