Nail lichen planus (NLP) is a chronic inflammatory condition that can lead to considerable cosmetic and functional impairment. Failure to administer prompt and effective treatment may result in the development of permanent scarring and nail loss. The precise pathogenesis of NLP remains poorly understood, and there is currently an absence of safe and effective treatment options.

Although not FDA-approved for the treatment of lichen planus, Janus kinase (JAK) inhibitors have shown considerable promise as therapeutic agents for a variety of dermatoses. We present a series cases of NLP treated by Upadacitinib, Abrocitinib and Ivarmacitinib, which are selective JAK1 inhibitors. Changes were recorded by dermoscopy and assessed using the Nail Lichen Planus Severity Index (NALSI) score. Following medication administration, most cases have shown satifying recovery of nail plates. The total score of the NALSI for the patient’s nail involvement have received noticable decreasing. No significant adverse drug reaction or serious adverse event has been reported.

Jianbo Zhong is an experienced dermatologist and dermatologic surgeon. He is current committee member of the Dermatologic Surgery & Cosmetic Dermatology Group of China Leprosy Association of China, committee member of Dermatologic Surgery Group of Society of Integrated Traditional and Western Medicine of China, Secretary-general and standing committee of Dermatology and Venereology of Zhejiang Society of Integrated Traditional and Western Medicine of China, Chief of Dermatologic Surgery Group of committee of Dermatology and Venereology of Society of Integrated Traditional and Western Medicine of Zhejiang Province, Standing committee of Cosmetic dermatology brach of Plastic Surgery Industry Association Committee of Zhejiang Province. He is the founder and group leader of dermatologic and nail surgery practice of Department of Dermatology and Venereology, Affiliated Hangzhou First People's Hospital, Hangzhou West Lake University. His current research interests are in research and comprehensive treatment of nail diseases, skin tumors, rosacea, hair diseases and medical aesthetics practice.