Alessia Paganelli, Laura Colonna, Biagio Didona, Giovanni Pellacani, Caterina Longo, Cristina Cristofoletti, Mauro Picardo
Lichen sclerosus (LS) is a chronic inflammatory dermatosis of the anogenital region with limited therapeutic options. Emerging evidence implicates dysregulation of the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway in LS pathogenesis, supporting investigation of targeted therapies. We report a series of 6 patients treated with topical ruxolitinib for vulvar LS, applied twice daily. Clinical outcomes were assessed using the Clinical Scoring System (CSS) and Patient Global Assessment (PtGA) over a mean follow-up of 7.5 months. All patients reported early symptomatic improvement in pruritus and burning. In parallel, PtGA scores showed significant improvement (p < 0.05). No local or systemic adverse events were observed. These findings suggest that topical JAK-STAT inhibition may represent a steroid-sparing option for achieving symptomatic improvement in LS, particularly in patients with concomitant autoimmune conditions. Larger controlled studies are warranted to confirm these preliminary observations.