Dupilumab-induced Acanthosis Nigricans

Abstract

Dupilumab is a human monoclonal IgG4 antibody to interleukin-4 (IL-4) and IL-13 approved for the treatment of moderate-to-severe atopic dermatitis (AD) in patients six months or older. Several cutaneous adverse reactions to dupilumab have been reported, including facial dermatitis and psoriasis. Herein, we present a unique case of dupilumab-induced acanthosis nigricans (AN) in a patient treated for concomitant AD and contact dermatitis, in the absence of other associated conditions or potential culprit medications. The patient had complete resolution of the lesions with discontinuation of medication, and recurrence upon re-initiation of therapy. This case represents a new cutaneous adverse reaction to dupilumab to which dermatologists should be familiar.