Abstract: Follicular occlusion triad (FOT) is a spectrum of disorders characterized by hyperkeratosis and occlusion of hair follicles accompanied by chronic recurrent inflammation, which responds poorly to conventional therapies. Interleukin-17A (IL-17A) is one of the key cytokines driving chronic inflammatory responses. Vunakizumab selectively binds to the IL-17A subunit and neutralizes its biological activity. To date, there have been no published reports regarding its application in the treatment of FOT. We report three patients with FOT who were refractory to conventional therapies. Baseline screening revealed no active infection or contraindications to biologic therapy. After 4 months of treatment, all patients experienced complete resolution of pain, marked regression of skin lesions, closure of sinus tracts, and normalization of inflammatory markers. Two patients achieved HiSCR60 and one achieved HiSCR70, accompanied by a substantial reduction in International Hidradenitis Suppurativa Severity Score System (IHS4) scores. No obvious adverse events were observed. These cases suggest that vunakizumab may have favorable short-term efficacy and safety in patients with follicular occlusion triad refractory to conventional treatment.

Key words: follicular occlusion triad, hidradenitis suppurativa, vunakizumab