Rapid therapeutic response in refractory lichen amyloidosis treated with upadacitinib: a case report

Lichen amyloidosis is a chronic skin disease characterized by amyloid deposition in dermal papillae, manifesting as severe itching and hyperpigmented papules. It is a refractory condition that typically responds only partially to conventional treatment including antihistamines and topical corticosteroids. This case report describes a 60-year-old Chinese male patient with a three-year history of progressive lichen amyloidosis affecting both limbs who failed multiple combined treatment regimens over two years. After receiving upadacitinib at a dose of 15 mg orally once daily, the patient achieved rapid remission—itching improved significantly within one month, with pain score decreasing from 8 to 1–2. Simultaneously, marked reduction in papules, decreased number of lesions, fading of pigmentation, and disappearance of skin changes were observed. No adverse effects were recorded during treatment. This case confirms the efficacy of JAK1 inhibitors in treating refractory lichen amyloidosis.