Abstract
Granulomatous rosacea (GR) is a rare and challenging subtype of rosacea that resists conventional therapies. Here, we present the case of a 56-year-old woman with a two-decade history of treatment-refractory GR who experienced significant clinical improvement with topical ruxolitinib, a Janus kinase (JAK) inhibitor, formulated as a 1.5% cream applied twice daily. After failing multiple established treatments, the patient achieved near-complete resolution of her condition following 10 months of combination therapy with topical ruxolitinib and metronidazole cream. This case highlights the potential efficacy of topical JAK inhibitors as a novel therapeutic approach for recalcitrant GR.