case_images: PMC10731305_01
case_images: (A) Skin infiltrative lesions during treatment with steroids and MMF (B) skin infiltrative lesions right before treatment with baricitinib; (C) skin after 18 months of treatment with baricitinib.
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case_images: However, cutaneous involvement remained uncontrolled, with severe facial erythematous infiltrative plaques and vasculitic lesions, which are associated with stable high titers of anti ds DNA and elevation of ESR, despite the addition of a topical steroid ( Figure 1A ). Skin involvement was refractory to multiple therapeutic approaches during the following years, which included monthly infusions of intravenous immunoglobulin (IVIG) (14 total infusions) and association with tacrolimus (1.5 mg twice a day) or azathioprine (100 mg/day) with steroid dependence and corticosteroid toxicity (hypertrichosis, weight gain, irritability) ( Figure 1B ).
case_images: Peripheral blood type I interferon signature of the patient before (A) and after (B) treatment with baricitinib. The panel shows the expression of six types of I-IFN stimulated genes, indicated in the X axis. Red bars indicate expression levels in the patient; black bars represent the average of 20 healthy donors. The interferon score (FI) is indicated in the legend.
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case_images: Furthermore, the INF signature result was strongly positive (18,81 v.n. <0,7) ( Figure 2 ).
case_images: (A) SLEDAI-2K score and (B) therapy timeline through the disease course. Figure steroids and therapy changes over time in correlation with the modification of the SLEDAI-2K.
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case_images: f3