In this case of a 50-year-old female with glucocorticoid-resistant acute severe urticaria, conventional therapies including systemic corticosteroids and antihistamines provided minimal relief. Given the persistent wheals, severe pruritus, and significant impact on quality of life, treatment with the selective JAK1 inhibitor upadacitinib was initiated. The patient demonstrated rapid and significant clinical improvement, with marked reduction in skin lesions and itching within days. This case highlights the potential role of JAK1 inhibition as an effective therapeutic option for patients with severe, refractory urticaria who do not adequately respond to standard treatment approaches.
