A 42-year-old woman with moderate-to-severe atopic dermatitis presents with a BSA of 24% and EASI score of 30. She has previously failed topical therapies, phototherapy, and dupilumab.

Her BMI is 30, baseline LDL is 108 mg/dL, and she has a history of PCOS and a maternal history of myocardial infarction at age 58. CBC and CMP results are normal.

After shared decision-making, you start upadacitinib 15 mg daily.

At 12 weeks, her BSA has dropped to approximately 3%, with an 85% improvement in EASI, and she reports that her sleep has normalized.

But her laboratory results complicate the picture: total cholesterol is 244 mg/dL, triglycerides are 176 mg/dL, LDL is 192 mg/dL, and HDL is 58 mg/dL.

Her 10-year ASCVD risk is calculated at 5.9%. A repeat lipid panel confirms the LDL elevation, A1C is 5.7%, and blood pressure is 130/82 mm Hg.

The care team consulted her PCP and initiated rosuvastatin 10 mg while continuing upadacitinib.

At 3-month follow-up, her atopic dermatitis remained well controlled. She reported no statin intolerance or adverse effects from the JAK inhibitor, and her cholesterol had stabilized.