[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-459095-105":59,"doc-detail-459095-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","erosive-oral-lichen-planus-treated-with-upadacitinib-amid-systemic-psoriatic-therapy","Erosive Oral Lichen Planus Treated With Upadacitinib Amid Systemic Psoriatic Therapy","","Erosive oral lichen planus (OLP) is a difficult immune-mediated mucocutaneous disorder often requiring escalation beyond topical therapy when refractory. A 41-year-old woman with psoriasis and psoriatic arthritis and biopsy-confirmed OLP developed worsening oral ulceration despite prednisone, topical agents, rinses, and mycophenolate. Multiple systemic adjustments were tried, including apremilast and certolizumab pegol, with limited benefit and treatment-limiting infections. Upadacitinib ultimately resolved OLP erosions and improved joint pain as a JAK1 inhibitor that may dampen chronic inflammatory signaling shared between PsA and lichen planus.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/erosive-oral-lichen-planus-treated-with-upadacitinib-amid-systemic-psoriatic-therapy/459095/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/erosive-oral-lichen-planus-treated-with-upadacitinib-amid-systemic-psoriatic-therapy/459095.png","ImageObject",300,407,{"name":92,"@type":93},"CatatanPagi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",16,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What treatments were tried before upadacitinib in this case of refractory erosive OLP?","Question",{"text":113,"@type":114},"The patient received prednisone, clobetasol gel, dexamethasone, chlorhexidine rinses, and mycophenolate. For systemic therapy, apremilast was ineffective and certolizumab pegol gave only partial relief before recurrent infections occurred.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Why is erosive oral lichen planus considered challenging to manage?",{"text":118,"@type":114},"It is a rare immune-mediated subtype that often does not respond well to first-line approaches. Ulceration can also make diagnostic assessment harder because it may interfere with histological features.",{"name":120,"@type":111,"acceptedAnswer":121},"How did upadacitinib affect the patient’s oral and joint symptoms?",{"text":122,"@type":114},"Upadacitinib was started at 15 mg daily and increased to 30 mg. At this dose, joint pain improved and the erosive OLP lesions resolved.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},459095,1790790968,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090894170,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review began 10/11/2025  \nReview ended 12/08/2025  \nPublished 12/09/2025  \n© Copyright 2025  \nAmes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98831  \nOpen Access Case Report  \nErosive Oral Lichen Planus Treated With Upadacitinib Amid Systemic Psoriatic Therapy  \nEmily Ames 1 , Maggie S. Sanders 1 , David Cotter 2, 1  \n1. School of Medicine, Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, Las Vegas, USA 2. Dermatology, Las Vegas Dermatology, Las Vegas, USA  \nCorresponding author: Emily Ames, [amese1@unlv.nevada.edu](amese1@unlv.nevada.edu)  \nAbstract  \nOral lichen planus (OLP) is a rare immune-mediated mucocutaneous disorder with several subtypes, including erosive OLP, which is particularly challenging to manage. First-line therapies are topical corticosteroids or calcineurin inhibitors, while erosive OLP may require intralesional triamcinolone. Refractory OLP requires systemic immunosuppressants. JAK inhibitors are a new consideration for refractory disease. A 41-year-old female with psoriasis (PsO), psoriatic arthritis (PsA), and biopsy-confirmed OLP presented with worsening oral ulceration. Previous treatments, including prednisone, clobetasol gel, dexamethasone, chlorhexidine rinses, and mycophenolate, provided little relief. As her OLP remained unresponsive to treatment, her psoriasis also proved challenging, necessitating multiple therapeutic adjustments. She was started on apremilast for her PsO and PsA, which was ineffective. She transitioned to certolizumab pegol, which provided partial relief but led to recurrent infections. Bimekizumab was then initiated, clearing her PsO, but leaving her with persistent joint pain. Given her persistent PsA, she was started on upadacitinib 15 mg daily, which was later increased to 30 mg. At this dose, her joint pain improved, and her OLP erosions resolved. Upadacitinib, a JAK1 inhibitor approved for PsA, reduces STATdependent inflammatory signaling. Studies show JAK1 and JAK3 overexpression in lichen planus (LP) inflammatory infiltrates, implicating JAK signaling in its pathogenesis. Given the inflammatory pathway overlap between PsA and LP, JAK inhibition may mitigate the chronic inflammatory cascade that drives erosive OLP. Upadacitinib’s efficacy in this case of refractory erosive OLP warrants further clinical studies to establish its therapeutic role.  \nCategories: Oral Medicine, Dermatology  \nKeywords: erosive oral lichen planus, jak-stat pathway, mucocutaneous disease, psoriasis, psoriatic arthritis, upadacitinib  \nIntroduction  \nOral lichen planus (OLP) is a rare chronic mucocutaneous disorder that affects approximately 1% of the global population, with the lowest reported prevalence (~0 .47%) in North America [1,2] . It is more prevalent in females and most often affects people between the ages of 30 and 80 years [3] . Although uncommon, malignant transformation occurs in approximately 1.4% of patients with OLP. Increased risk has been associated with smoking, alcohol use, hepatitis C infection, lingual involvement, and the presence of erythematous lesions [2] . OLP is thought to be a T-cell-mediated inflammatory condition. While the antigenic trigger remains unknown, OLP is thought to arise in genetically predisposed individuals in response to factors such as mechanical or chemical irritation, psychological stress, immune or endocrine system dysregulation, and viral infections [4-6].  \nThe clinical presentation of OLP is variable, ranging from asymptomatic white keratotic lesions to painful erosions and ulcerations found in the erosive form of the disease [5] . Erosive OLP can present as an ulcerated red, inflamed area that can contain a white lacy pattern; it is often associated with pain, soreness, or a burning se","cbCaiuqRqfdBePhl","https://ap.wps.com/l/cbCaiuqRqfdBePhl","pdf",1237504,"English","# Abstract\n# Introduction\n## Clinical features and diagnosis of OLP\n## Mimickers and differential diagnosis\n## Histopathologic confirmation and follow-up","[{\"question\":\"What treatments were tried before upadacitinib in this case of refractory erosive OLP?\",\"answer\":\"The patient received prednisone, clobetasol gel, dexamethasone, chlorhexidine rinses, and mycophenolate. For systemic therapy, apremilast was ineffective and certolizumab pegol gave only partial relief before recurrent infections occurred.\"},{\"question\":\"Why is erosive oral lichen planus considered challenging to manage?\",\"answer\":\"It is a rare immune-mediated subtype that often does not respond well to first-line approaches. Ulceration can also make diagnostic assessment harder because it may interfere with histological features.\"},{\"question\":\"How did upadacitinib affect the patient’s oral and joint symptoms?\",\"answer\":\"Upadacitinib was started at 15 mg daily and increased to 30 mg. At this dose, joint pain improved and the erosive OLP lesions resolved.\"}]","Erosive Oral Lichen Planus Treated With Upadacitinib Amid Systemic Psoriatic Therapy | PDF",1790755190,13]