ACKNOWLEDGMENTS
I would like to thank Dr. Rui Zheng for her kind guidance on this paper.
Figure 1 Hyperkeratosis, epidermal hyperplasia, and fissures
can be seen at the junction of the true epidermis, inflammatory cells,
mainly lymphocytes, were seen around the vessels in the superficial
dermis (A, scale bar: 50μm). Epidermis showed subepidermal bulla. Dermis
shows mixed inflammatory infiltrate (B, HE×40). multiple reddish-brown
hemispherical mung bean-to-soybean-sized nodules were symmetrically
distributed on the bilateral calves and right thigh, densely packed in
patches, some of which were anabrotic and crustosus due to the intense
itching (C and D). After 2 years of baricitinib treatment, the results
uncovered that the number of skin rashes on the outer side of both
thighs had decreased by half, and the color had become dull, although
some dark brown hyperpigmentation and scars remained on the extensor
aspect of both lower legs (E and F).
Figure 2 Change in VAS after oral baricitinib treatment showed
a gradual downward trend, Patient’s past and current treatment plan.