Abstract
Lichen planus is a chronic inflammatory disorder, with vulvar variants often resistant to multiple treatments. The primary therapeutic goals for vulvar lichen planus are to prevent scarring and the development of squamous cell carcinoma. Management also involves treating associated symptoms such as pruritus and pain. This report describes a 50-year-old female with treatment-resistant hypertrophic and erosive vulvar lichen planus. Despite extensive trials of various therapies, the patient experienced symptoms of pruritus, pain, and repeated flares, significantly affecting her quality of life. Abrocitinib, a highly selective Janus kinase 1 inhibitor, was added to her treatment regimen, leading to a 95% resolution of lesions and substantial improvement in quality of life. This case highlights the potential of abrocitinib as an effective, novel off-label treatment for recalcitrant vulvar lichen planus.