Sibel YILDIZ, Selami Aykut TEMİZ, Mehmet ASIL, Sena DOĞAN, Pembe OLTULU
Turkish Journal of Dermatology - 2026;20(3):95-100
The use of Janus kinase (JAK) inhibitors has been rapidly increasing, particularly in immune-mediated conditions, including severe and treatment-refractory inflammatory bowel disease, rheumatologic disorders, and dermatologic conditions such as atopic dermatitis (AD). By inhibiting the JAK/signal transducer and activator of transcription signaling pathway, these agents suppress proinflammatory cytokine production and modulate immune responses. However, as a consequence of this potent immunomodulatory activity, immune-mediated paradoxical reactions-most notably paradoxical psoriasis-may occasionally occur. Although paradoxical psoriasis associated with JAK inhibitors has only rarely been reported in the literature, its true incidence is likely higher. This review synthesizes the current evidence, discusses the proposed pathophysiological mechanisms, and provides an updated perspective on clinical management strategies. This comprehensive evaluation is expected to enhance clinical awareness of paradoxical psoriasis arising during JAK inhibitor therapy and to contribute to improved diagnostic and therapeutic approaches.
