Development or Exacerbation of Head and Neck Dermatitis in Patients Treated for Atopic Dermatitis With Dupilumab

Soria, Angèle; Du‐Thanh, Aurélie; Sénéschal, Julien; Jachiet, Marie; Staumont‐Sallé, D.; Barbarot, S.

doi:10.1001/jamadermatol.2019.2613

Cited by 62 publications

(53 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite IL‐4 levels being reported to be increased in some cases of SD, IL‐4 blockade might actually worsen SD. It has been proposed that specifically head and neck dermatitis, a well‐known side effect of dupilumab, might be due to increased levels of IL‐17 in lesional skin . In 2018, Wikramanayake et al demonstrated increased levels of IL‐17 expressing γδ T cells in Mpzl3 knockout mice.…”

Section: Future Directionsmentioning

confidence: 72%

See 1 more Smart Citation

An update on the microbiology, immunology and genetics of seborrheic dermatitis

Aðalsteinsson

Kaushik

Muzumdar

et al. 2020

Experimental Dermatology

View full text Add to dashboard Cite

The underlying mechanism of seborrheic dermatitis (SD) is poorly understood but major scientific progress has been made in recent years related to microbiology, immunology and genetics. In light of this, the major goal of this article was to summarize the most recent articles on SD, specifically related to underlying pathophysiology. SD results from Malassezia hydrolysation of free fatty acids with activation of the immune system by the way of pattern recognition receptors, inflammasome, IL-1β and NF-kB. M. restricta and M. globosa are likely the most virulent subspecies, producing large quantities of irritating oleic acids, leading to IL-8 and IL-17 activation. IL-17 and IL-4 might play a big role in pathogenesis, but this needs to be further studied using novel biologics. No clear genetic predisposition has been established; however, recent studies implicated certain increased-risk human leucocyte antigen (HLA) alleles, such as A*32, DQB1*05 and DRB1*01 as well as possible associations with psoriasis and atopic dermatitis (AD) through the LCE3 gene cluster while SD, and SD-like syndromes, shares genetic mutations that appear to impair the ability of the immune system to restrict Malassezia growth, partially due to complement system dysfunction. A paucity of studies exists looking at the relationship between SD and systemic disease. In HIV, SD is thought to be secondary to a combination of immune dysregulation and disruption in skin microbiota with unhindered Malassezia proliferation. In Parkinson's disease, SD is most likely secondary to parasympathetic hyperactivity with increased sebum production as well as facial immobility which leads to sebum accumulation. K E Y W O R D Sinflammasome, Malassezia, sebaceous glands, seborrheic dermatitis, systemic disease While the order of events is unclear regarding the pathophysiology of SD, it is agreed upon by most sources that the three main prerequisites are as follows: Malassezia colonization, lipid secretion by sebaceous glands and an underlying immune system susceptibility. [1,5,7,38] The pathogenesis can be categorized into five different phases.

show abstract

Section: Future Directionsmentioning

confidence: 72%

“…This was the first time IL‐17 had been shown to be increased in SD . Th17 activity might be increased in SD at baseline, which could be worsened further with IL‐4 blockade . This is supported further by the fact that head and neck dermatitis responds to fluconazole in many cases.…”

Section: Future Directionsmentioning

confidence: 99%

An update on the microbiology, immunology and genetics of seborrheic dermatitis

Aðalsteinsson

Kaushik

Muzumdar

et al. 2020

Experimental Dermatology

View full text Add to dashboard Cite

show abstract

“…Fewer serious/severe bacterial infections and other non-herpetic skin infections were observed among patients using dupilumab [ 33 ]. Among the side effects with long-term use of dupilumab, paradoxical erythema of the face, décolleté and neck, usually after 10–39 weeks of using dupilumab, has been reported [ 34 , 35 ]. In the group of adolescents > 12 years of age treated with dupilumab, a higher percentage of conjunctivitis and reactions at the injection site and lower rates of non-herpetic skin infections were observed [ 21 ].…”

Section: Biological Drugs In Atopic Dermatitismentioning

confidence: 99%

Biological drugs in the treatment of atopic dermatitis – current recommendations of the Polish Dermatological Society, the Polish Society of Allergology, the Polish Pediatric Society and the Polish Society of Family Medicine

Nowicki¹,

Trzeciak²,

Rudnicka³

et al. 2020

pdia

View full text Add to dashboard Cite

“…A multi-institution retrospective medical record review revealed that dupilumab-induced facial redness was seen in approximately 10% of patients treated with dupilumab in daily practice [12]. A French national retrospective study found that approximately 4% of patients taking dupilumab developed head and neck dermatitis [13]. A recent case report has suggested that this dupilumab-induced facial redness is attributable to hypersensitivity to Malassezia species and advocates for the use of oral itraconazole in the management of this symptom [14].…”

Section: Dupilumab (Dupixent®)mentioning

confidence: 99%

Cutaneous Adverse Events in Newly Approved FDA Non-cancer Drugs: A Systematic Review

et al. 2020

View full text Add to dashboard Cite

The prevalence of cutaneous adverse events attributable to newly approved anti-cancer drugs has been well reviewed in the dermatologic literature. In contrast, over 75% of US Food and Drug Administration approvals in the past 5 years have been for non-cancer drugs and indications. This represents multiple other categories of approved medications associated with cutaneous adverse reactions. To investigate the cutaneous adverse events associated with these potentially neglected medications, a systematic review was conducted. Two hundred and forty-one medications approved by the Food and Drug Administration between 2013 and 2018 were reviewed and 180 non-oncologic drugs were identified. The prescribing information for each medication was reviewed for the presence of cutaneous adverse events and a supplemental literature search was performed to better characterize any adverse events outlined within the prescribing information. Most reactions were classified as morbilliform, macular, popular, or maculopapular. Fortunately, only a few severe cutaneous adverse reactions were reported, namely in benznidazole, cannabidiol, and sofosbuvir. This review summarizes available data drawn from clinical trials and case reports involving cutaneous adverse events from the 21 non-oncologic medications associated with cutaneous adverse events.

show abstract

Development or Exacerbation of Head and Neck Dermatitis in Patients Treated for Atopic Dermatitis With Dupilumab

Cited by 62 publications

References 7 publications

An update on the microbiology, immunology and genetics of seborrheic dermatitis

An update on the microbiology, immunology and genetics of seborrheic dermatitis

Biological drugs in the treatment of atopic dermatitis – current recommendations of the Polish Dermatological Society, the Polish Society of Allergology, the Polish Pediatric Society and the Polish Society of Family Medicine

Cutaneous Adverse Events in Newly Approved FDA Non-cancer Drugs: A Systematic Review

Contact Info

Product

Resources

About