Janus kinase inhibitors as a breakthrough treatment for refractory dissecting cellulitis of the scalp

Background: Dissecting cellulitis of the scalp (DCS) is a rare, chronic neutrophilic dermatosis that is often refractory to conventional therapies. Case report: We present a 29-year-old male with treatment-resistant DCS who achieved rapid and sustained remission following off-label use of tofacitinib, a Janus kinase (JAK) inhibitor. Previous therapies, including antibiotics, corticosteroids, and isotretinoin, had failed. After 9 weeks of tofacitinib 10 mg daily, the patient showed marked improvement and maintained remission for 6 months without side effects. Conclusion: This case supports JAK inhibitors as a promising therapeutic strategy in refractory DCS, highlighting their potential role in managing challenging inflammatory dermatoses.