Netherton syndrome (NS) is an orphan disease characterized by congenital ichthyosis, hair abnormalities, and atopy, with limited treatment options. We achieved temporary improvement only during the initial 6 weeks of treatment with dupilumab, which differs from the sustained improvement observed in 2 other recently published cases. Although the clinical presentation of atopy and increased pre-allergic cytokines in NS patients suggest that dupilumab may be beneficial, larger studies are required.

Atopic dermatitis (AD) is a common, chronic inflammatory condition with a substantial negative impact on the quality of life. Dupilumab, the first biologic approved for the treatment of moderate-to-severe AD, binds IL-4Rα and inhibits signaling of both IL-4 and IL-13. This study aimed to determine the real-life effectiveness and safety of dupilumab treatment in patients with moderate-to-severe AD. The results of the study indicates high effectiveness and safety of dupilumab in real-life conditions. The treatment was continued during the COVID-19 pandemic in most of the patients without any adverse outcome. The rate of conjunctivitis was higher compared to clinical trials, nevertheless treatment was not discontinued in any patients due to adverse effects.

Omalizumab is a well-established treatment option in chronic spontaneous urticaria unresponsive to antihistamines at standard or higher doses. However, characteristics of the remission and relapse following the withdrawal of omalizumab remain largely unknown. We aimed to define the characteristics of remission in CSU following omalizumab with gradually lengthened dosing intervals in this retrospective study of 102 patients who were treated with at least 3 doses of omalizumab between 2013 and 2020. Of 102 patients, 70 (68.6%) showed a CR to omalizumab at standard doses. Omalizumab could be discontinued in 47 of 70 patients using gradually lengthened dosing intervals. Following a mean follow-up duration of 12.2 months, 25 (58.1%) patients were still in remission while 18 (41.9%) had relapse (Follow-up data were not available in 4 patients). The relapses were unresponsive to antihistamines in 14 patients (77.7%), however, retreatment with omalizumab led to complete control of symptoms. The patients younger than 40 were more likely to relapse. Despite the need for comparison with fixed-dosing intervals in larger, prospective studies, the results of this study imply that omalizumab with gradually extended dosing intervals might provide a long duration of remission in CSU.

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Background: SARS-Cov 2 2019 (C-19) infection affects the course of various dermatological diseases. However, data on its impact on psoriasis course is limited. Objectives: To evaluate the impact of C-19 infection on psoriasis course and also investigate the frequency of post-covid complications in psoriasis patients. Methods: Psoriasis patients with at least one C-19 PCR positivity, having a control visit between March and June 2022 were included. The flare was defined as at least 25% increase in psoriasis severity within 4 weeks after C-19 PCR positivity, according to patient-reported assessment. As confounders, corticosteroid and hydroxychloroquine use and vaccination against SARS-Cov2 histories within the last 4 weeks were questioned. Also, post-covid complications were recorded. Results: 105 patients (50 female, 55 male) with a total of 113 C-19 incidents were included. Psoriasis exacerbation following C-19 was observed in 23.8% (n:25) of patients. Among 22 patients, exacerbation was similar to baseline psoriasis phenotype (1 guttate, 2 generalized pustular, 19 plaque) whereas in 3 patients with plaque psoriasis, guttate (2) and generalized pustular (1) psoriasis emerged. The risk of post-covid psoriasis flare was found to be related with discontinuation of medications or unstable psoriasis during C-19. Six patients developed post-covid complications including pericardial effusion, pulmonary thromboembolism, cerebrovascular accident, fascial paralysis and arthritis. Conclusion: This study shows a high risk of psoriasis flare following C-19, which is mostly related to unstable psoriasis during C-19 or discontinuation of medications. Since psoriasis patients have increased risk of cardiovascular complications, careful follow-up for mainly thrombotic post-covid complications is mandatory. IRB approval status: Reviewed and approved by Marmara University School of Medicine IRB (Approval number: 09.2022.339)