IntroductionNLP is an inflammatory, relatively rare disorder involving mainly the nail matrix, frequently having its onset in adulthood and generally involving one or more nails or toenails [1]. The management of NLP is not easy due to a high rate of failures after therapy and few therapeutic options, especially when the process reaches the stage of dorsal pterygium [1]. Janus kinase (JAK) inhibitors are potential therapeutic targets for inflammatory skin diseases. They have been demonstrated to suppress both type-1 and type-2 cytokines and decrease the immune response, leading to inflammation [2]. This paper reports a case of severe NLP showing a good response to the JAK inhibitor (Tofacitinib).