AbstractPityriasis rubra pilaris (PRP) is a rare papulosquamous skin condition that affects both adults and the pediatric population. It is characterized by salmon-colored plaques with islands of sparing and palmoplantar hyperkeratosis. Currently, there are no established guidelines for PRP treatment, especially in pediatric patients. In this study, we presented an infant case of type III juvenile PRP successfully treated with a short-term, low-dose cyclosporine A (CsA). No recurrence occurred during the 3-month follow-up period after completing treatment. Additionally, we reviewed the use of CsA as an alternative treatment option for juvenile-onset PRP. The results of this study were consistent with previous findings for adult-onset PRP. Therefore, this study further supports using CsA as an alternative option for treating juvenile-onset PRP.

Introduction:Lichen Planus is a skin disease that can also affect the mucous membranes and nails (1, 2). The skin manifestations of this disease are multiple purple papules often accompanied by itching (3). The mucosal involvement of this disease is known as mucosal erosions that often involve the oral mucosa and genital area (4).One of the rare types of this skin disease is called ulcerative lichen planus, which presents as chronic ulcers resistant to treatment, associated with pain and many disabilities for patients (5, 6). The involvement of the soles of the feet is one of the most significant areas affected by ulcerative lichen planus. Despite several treatment options having been studied in the past, treating plantar ulcerative lichen planus remains a challenge for dermatologists (4-8).Tofacitinib, a Janus Kinase inhibitor, has a special place in the treatment of inflammatory diseases in medicine (9). Recently, studies have shown its effectiveness in treating various skin diseases such as psoriasis, alopecia areata, vitiligo, and atopic dermatitis (10). In recent studies, the effectiveness of this drug in treating certain types of lichen planus has been mentioned, including lichen planopilaris and erosions of the oral mucosa (9, 11).In this article, we presented a case of plantar ulcerative lichen planus that was initially resistant to treatment but exhibited a remarkable response upon being treated with oral tofacitinib. In addition, we conducted a comprehensive review of literature on the efficacy of tofacitinib in treating various types of lichen planus lesions, while also discussing other proposed treatments for plantar ulcerative lichen planus.