Treatment of Refractory Folliculitis Decalvans With the Topical JAK Inhibitor Tofacitinib

A male patient in his 50s with refractory folliculitis decalvans (FD) of the scalp, unresponsive to various treatments including antibiotics, steroids, and surgical excision, experienced significant improvement after using topical tofacitinib, a Janus Kinase inhibitor (JAKi), twice daily. After four months, his FD became clinically quiescent, and he reported complete resolution of pain and draining sinus tracts. This case highlights the potential effectiveness of topical JAK inhibitors in treating FD, a condition that is typically difficult to manage with conventional therapies.