Pretibial myxedema (PTM), an uncommon manifestation of autoimmune thyroid disease, may affect up to 5% of patients with Graves disease.¹ PTM is characterized by the accumulation of glycosaminoglycans in the dermis and subcutaneous tissue, typically involving the anterior shins.

Current treatment options, including topical and intralesional steroids, surgery, UV-A1 phototherapy, and compression bandages, are often unsatisfactory.¹ The Janus kinase–signal transducer and activator of transcription (JAK-STAT) signaling pathway is pivotal for T-cell activation, differentiation, and function.² Fibroblasts stimulated by T-cell cytokines promote the secretion of glycosaminoglycans in PTM lesions.^2,3 We hypothesized that JAK inhibitors may be beneficial for treating PTM. Herein, favorable responses were reported in 2 patients with PTM treated with tofacitinib, a Jak1/Jak3 inhibitor.