Improvement of Recalcitrant Dissecting Cellulitis of the Scalp After a Trial of Upadacitinib

A 26-year-old male with recalcitrant dissecting cellulitis of the scalp (DCS) showed significant clinical improvement after a short course of upadacitinib, a Janus kinase (JAK) inhibitor. Previous treatments, including topical antimicrobials, oral antibiotics, corticosteroids, and intralesional triamcinolone injections, had limited success. Upadacitinib reduced the patient's pain, pustular draining, and bleeding, and improved his quality of life. This case suggests that JAK inhibitors may be a promising therapy for refractory DCS, a condition with few effective treatment options.