<i>De novo</i> psoriasis in atopic dermatitis patients treated with dupilumab: a retrospective cohort

Jaulent, L.; Staumont‐Sallé, D.; Tauber, M.; Paul, C.; Aubert, H.; Marchetti, A.; Sassolas, B.; Valois, A.; Nicolas, Jean-François; Nosbaum, Audrey

doi:10.1111/jdv.17050

Cited by 30 publications

(35 citation statements)

References 16 publications

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“…[1][2][3][4] However, the development of psoriasiform eruptions and psoriasis after initiation of dupilumab was first described in case reports of adults after approval by the Food and Drug Administration for this age group. [5][6][7][8][9][10][11] Biopsies in adult patients have shown characteristic features of psoriasis (eg, parakeratosis, hyperkeratosis, acanthosis with elongated rete ridges, absence of the granular layer, dilated capillaries, perivascular lymphocytic infiltrates and, in some cases, Munro's microabscesses in the stratum corneum, but without epidermal spongiosis or eosinophils). [6][7][8] Here we present a series of seven children aged 4-18 years old, six of whom developed psoriasiform eruptions concurrent with improvement in the AD while taking dupilumab and a 7th whose unrecognized psoriasis was revealed when her concomitant severe AD responded to dupilumab.…”

Section: Introductionmentioning

confidence: 99%

Psoriasiform dermatitis during dupilumab treatment for moderate‐to‐severe atopic dermatitis in children

Parker

Sugarman

Silverberg

et al. 2021

Pediatric Dermatology

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Background/Objectives: Psoriasiform eruptions after initiation of dupilumab have been previously described in adults. This report details the risk of developing or unmasking psoriasiform eruptions after initiation of dupilumab in children. Methods:Records of patients ≤18 years of age with atopic dermatitis who developed psoriasiform dermatitis during treatment with dupilumab were reviewed retrospectively.Results: Six children, 4-18 years of age, on dupilumab for severe atopic dermatitis developed new-onset psoriasiform dermatitis at a median duration of 8 months (range, 6-12 months) after dupilumab initiation. Typical locations of psoriasis were involved (face, scalp, trunk, and extensor extremities). The majority showed clearance or near clearance with the use of medium-strength to potent topical corticosteroid ointments and 83% continued use of the dupilumab. A 7th patient had psoriasis, in addition to severe atopic dermatitis, and the psoriasis was unmasked by its failure to respond to dupilumab. Conclusion:Although unusual, psoriasiform lesions can appear during effective treatment with dupilumab for atopic dermatitis, potentially reflecting a shift toward cutaneous IL-23/T H 17 pathway activation with dupilumab-induced suppression of type 2 immunity.

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Section: Introductionmentioning

confidence: 99%

Psoriasiform dermatitis during dupilumab treatment for moderate‐to‐severe atopic dermatitis in children

Parker

Sugarman

Silverberg

et al. 2021

Pediatric Dermatology

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“…For example, psoriasis has been reported in dupilumab-treated patients with AD with pathophysiology attributed to a shift of Th2 to Th17/interleukin 23 bioactivity, the latter axis a known inducer of this cutaneous disease. 10 Until further data are known, we recommend that caution be used when prescribing dupilumab in people with MS.…”

Section: Discussionmentioning

confidence: 99%

Relapsing-remitting multiple sclerosis arising in a patient with atopic dermatitis on dupilumab

et al. 2021

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“…[20] De novo psoriasis is a rare side effect of dupilumab treatment, but one that the treating physician must be aware of. [21] Patients treated with dupilumab (n = 373) were screened for new onset psoriasis in a retrospective cohort study conducted over a 3-year period in six French centers. At a mean duration of 16 weeks after starting dupilumab therapy, seven patients developed either plaque, pustular or nail psoriasis.…”

Section: Safety and Adverse Effectsmentioning

confidence: 99%

“…To better understand the prevalence, mechanisms, and possible risk factors of this adverse effect, further research is required. [21] DUPILUMAB [22] e recommended dose, given by SC injection, is initially 600 mg (2 × 300 mg injections), followed by 300 mg given every other week. [23] Patients are trained to self-inject dupilumab.…”

Section: Safety and Adverse Effectsmentioning

confidence: 99%

Dupilumab in the treatment of moderate-to-severe atopic dermatitis: A focused review

Deif

Bali

Rajeev

2021

JSSTD

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Atopic dermatitis (AD) is a chronic inflammatory skin condition causing significant decline in quality of life. Moderate-to-severe AD is refractory to first-line topical therapy, while systemic immunosuppressants can have significant adverse effects. Dupilumab is a fully human monoclonal antibody and the first food and drug administration approved biologic therapy for the treatment of adults with moderate-to-severe AD. It inhibits the actions of both interleukin (IL)-4 and IL-13, two T helper cell type 2 cytokines involved in the pathogenesis of AD. Dupilumab has been found to be an efficacious treatment option in AD with its main adverse reactions being conjunctivitis, injection site reaction, and facial redness. Dupilumab is known to improve the severity and extent of AD, as measured by the eczema area severity index and dermatology life quality index. A similar observation was made by the authors in 30 patients. Thus, dupilumab represents a valuable new treatment option for moderate-to-severe AD, however, high cost remains a major consideration.

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De novo psoriasis in atopic dermatitis patients treated with dupilumab: a retrospective cohort

Cited by 30 publications

References 16 publications

Psoriasiform dermatitis during dupilumab treatment for moderate‐to‐severe atopic dermatitis in children

Psoriasiform dermatitis during dupilumab treatment for moderate‐to‐severe atopic dermatitis in children

Relapsing-remitting multiple sclerosis arising in a patient with atopic dermatitis on dupilumab

Dupilumab in the treatment of moderate-to-severe atopic dermatitis: A focused review

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