Onset of Schamberg Disease and Resolution of Alopecia Areata During Treatment of Atopic Dermatitis With Dupilumab

Szekely, Serena; Vaccari, Daniele; Salmaso, Roberto; Fortina, Anna Belloni; Alaibac, Mauro

doi:10.18176/jiaci.0541

Cited by 7 publications

(4 citation statements)

References 10 publications

(18 reference statements)

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“…At the end of week 24, 10% (4/40) of patients in the treatment arm achieved SALT 50 compared to none in the placebo arm (Table 4). These results corroborated the findings from multiple case‐series studies and case reports demonstrating the potential efficacy of dupilumab 49–52 …”

Section: Resultssupporting

confidence: 87%

“…These results corroborated the findings from multiple case-series studies and case reports demonstrating the potential efficacy of dupilumab. [49][50][51][52] Despite the encouraging results, multiple studies have also reported on the paradoxical of dupilumab in the development, exacerbation or reactivation of AA. [53][54][55][56] The inhibition of IL-4 may skew the CD4 + T cells towards the T helper 1/T helper 17 type response, which have been implicated in the immunopathogenesis of AA (Figure 2).…”

Section: Clinical Studiesmentioning

confidence: 99%

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Systematic review of newer agents for the management of alopecia areata in adults: Janus kinase inhibitors, biologics and phosphodiesterase‐4 inhibitors

Gupta

Wang

Ravi

et al. 2022

Acad Dermatol Venereol

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Management options for moderate‐to‐severe alopecia areata (AA) are limited owing to a lack of safe and effective treatments suitable for long‐term use. However, newer agents have the potential to induce and maintain hair regrowth in patients with a better side‐effects profile compared to systemic steroids or conventional systemic agents. In this article, we conducted a systematic review of newer agents, including Janus kinase (JAK) inhibitors, biologics and phosphodiesterase‐4 (PDE‐4) inhibitors, for the treatment of AA in adult patients evaluated in randomized controlled trials (RCTs) using the Severity of Alopecia Tool score. A literature search was performed on PubMed and ClinicalTrials.gov, which identified 106 items with 12 RCTs eligible for review. Information regarding the treatment regimen, duration, endpoints, efficacy and adverse events were extracted; product monograph information was also summarized for approved agents with or without indications for AA. Overall, current data suggest the oral JAK inhibitors (baricitinib, ritlecitinib, deuruxolitinib, brepocitinib) as a promising new class of agents that can induce significant hair regrowth, with mild to moderate adverse effects. Baricitinib recently received US FDA approval for the treatment of severe AA, while ritlecitinib and deuruxolitinib have received the breakthrough therapy designation for AA. In contrast, PDE‐4 inhibitors (apremilast) and the biologics (dupilumab, secukinumab and aldesleukin) appear to have limited efficacy thus far. Results from ongoing and future long‐term studies could shed light on the utility of the newer agents in altering the progression of AA.

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Section: Resultssupporting

confidence: 87%

Section: Clinical Studiesmentioning

confidence: 99%

Systematic review of newer agents for the management of alopecia areata in adults: Janus kinase inhibitors, biologics and phosphodiesterase‐4 inhibitors

Gupta

Wang

Ravi

et al. 2022

Acad Dermatol Venereol

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“…One case of incontinentia pigmenti-associated scalp alopecia was reported. Clinical responses were mostly measured by the severity of alopecia tool (SALT) with a score < 10 defined as complete response ( Table 4 ) [ 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163 , 164 , 165 , 166 , 167 , 168 , 169 , 170 , 171 ]. Noticeably, 13 pediatric patients were treated effectively with dupilumab [ 172 , 173 , 174 , 175 , 176 , 177 ].…”

Section: Resultsmentioning

confidence: 99%

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

et al. 2023

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Dupilumab was first approved for the treatment of atopic dermatitis (AD) and blocks the signaling of interleukin (IL)-4 and -13. Several other chronic skin conditions share mechanistic overlaps with AD in their pathophysiology, i.e., are linked to type 2 inflammation. Most recently, dupilumab was approved by the U.S. Food and Drug Administration for prurigo nodularis (PN). Given its relatively good safety profile, effective off-label use of dupilumab has been reported for a multitude of dermatologic diseases and several clinical trials for dermatologic skin conditions are currently ongoing. We conducted a systematic review of applications of dupilumab in dermatology other than AD and PN by searching the databases PubMed/Medline, Scopus, Web of Science and Cochrane Library as well as the clinical trial registry ClinicalTrials.gov. We found several reports for effective treatment of bullous autoimmune diseases, eczema, prurigo, alopecia areata, chronic spontaneous urticaria, Netherton syndrome and a variety of other chronic inflammatory skin diseases.

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“…Although the exact cause of Schamberg disease is not well understood, certain medications have been implicated in the development or exacerbation of the disease, including amlodipine [ 23 , 24 ], raloxifene [ 25 ], dupilumab [ 26 ], and TNF-alfa inhibitors [ 27 ]. Alcohol [ 28 ], physical exercise [ 29 ], and odontogenic infection [ 30 ] have been attributed a possible pathogenic role in SD as well.…”

Section: Triggering Factors Of Ppdmentioning

confidence: 99%

Therapeutic Approach in Pigmented Purpuric Dermatoses—A Scoping Review

Kimak,

Żebrowska

2024

IJMS

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Pigmented purpuric dermatoses (PPD) encompass a group of chronic skin conditions characterized by the presence of petechiae, purpura, and pigmentation changes. While generally benign, these dermatoses can be persistent and aesthetically bothersome. Key clinical features include red to brownish patches with a distinctive “cayenne pepper” appearance, predominantly localized on the lower extremities, particularly the shins. Subtypes include Schamberg disease, Majocchi’s disease, Gougerot–Blum disease, Ducas and Kapetanakis pigmented purpura, and lichen aureus. Diagnosis relies primarily on clinical evaluation of skin lesions, with biopsy as a confirmatory tool. Although the exact cause of PPD remains unclear, capillary fragility and red blood cell extravasation are implicated. Treatment strategies for PPD aim to alleviate symptoms, considering the generally benign and chronic nature of the condition. As there is no standardized treatment, various methods with varying efficacy are employed. After searching SCOPUS and PubMed databases, we assessed 42 original articles to present current knowledge regarding therapy of PPD. This review will compare treatment approaches specifically in Schamberg disease and other manifestations of pigmented purpuric dermatoses.

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Onset of Schamberg Disease and Resolution of Alopecia Areata During Treatment of Atopic Dermatitis With Dupilumab

Cited by 7 publications

References 10 publications

Systematic review of newer agents for the management of alopecia areata in adults: Janus kinase inhibitors, biologics and phosphodiesterase‐4 inhibitors

Systematic review of newer agents for the management of alopecia areata in adults: Janus kinase inhibitors, biologics and phosphodiesterase‐4 inhibitors

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

Therapeutic Approach in Pigmented Purpuric Dermatoses—A Scoping Review

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