Abstract: Upadacitinib, a highly selective JAK1 inhibitor, has been approved in China for the treatment of multiple immune-mediated disorders including atopic dermatitis, rheumatoid arthritis, psoriatic arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis, demonstrating therapeutic applications across dermatological, gastroenterological, and rheumatological domains. Recent studies have shown that it exhibits significant efficacy in autoimmune diseases or inflammatory dermatoses such as hidradenitis suppurativa, alopecia areata, vitiligo, and palmoplantar pustulosis. This review comprehensively summarizes the pharmacological mechanisms, clinical efficacy, and safety profile of upadacitinib, integrating data from recent randomized controlled trials and real-world studies to evaluate its expanding therapeutic potential in dermatology. The synthesis of current evidence aims to provide clinicians with evidence-based guidance for optimizing treatment strategies in inflammatory skin disorders.

Key words: upadacitinib, inflammatory dermatoses, off-label use