Clinical Characteristics and Time to Onset of JAK-Inhibitor-Associated Acne: A Retrospective Chart Review Study.

Abstract

Background: Acne is a common cutaneous adverse event associated with Janus kinase (JAK) inhibitors, with incidence varying across agents. Substantial increase in JAK inhibitor use has been accompanied by presentation of acne as a side effect, yet data describing its clinical features remain limited. This paper aims to characterize the demographic features, timing, and clinical presentation of acne associated with oral JAK inhibitor therapy across multiple agents.

Methods: We conducted a retrospective chart review of patients treated at Mount Sinai Dermatology who were prescribed oral JAK inhibitors (tofacitinib, baricitinib, upadacitinib, abrocitinib, or ritlecitinib) and had a documented diagnosis of acne. Data collected included patient demographics, JAK inhibitor type, treatment indication and duration, and acne characteristics, including distribution and time to onset. Descriptive statistics were reported as n (%), mean ± SD, or median (IQR).

Results: Fifty-seven (57) patients developed acne while receiving JAK inhibitors. The cohort was predominantly female (70%) and White (53%), with a mean age of 34.2 ± 13.2 years. Upadacitinib was the most frequently implicated agent (72%), followed by tofacitinib (11%), baricitinib (7%), abrocitinib (5%), and ritlecitinib (5%). For those with documented treatment initiation dates, the median time from JAK inhibitor initiation to acne diagnosis was 91 days (IQR, 33.5–198).

Conclusion: Acne is an increasingly observed dermatologic adverse event in patients treated with JAK inhibitors. This study further characterizes the timing and clinical presentation of JAK-induced acne and may enhance patient counseling, clinical monitoring, and management strategies as JAK inhibitor use continues to expand.  .