Patch Testing in a Patient on Dupilumab

Repeat patch testing in a patient with allergic contact dermatitis improved on dupilumab

“…Positive patch test reactions while receiving dupilumab have been reported, showing that these patients are capable of mounting an acute reaction upon allergen exposure; however, it is possible that patients with chronic ACD might benefit from dupilumab therapy despite remaining competent to elicit acute ACD on patch testing 4, 5. Our patient experienced significant clinical improvement on dupilumab but continued to have positive patch test reactions to Ni and MI.…”

Use of dupilimab in pediatric atopic dermatitis: Access, dosing, and implications for managing severe atopic dermatitis

“…An emerging adverse effect recently reported as possibly related to dupilumab is a poorly characterized facial eruption, of unclear etiology . In some of these cases, allergic contact dermatitis has been suspected, based on a possible drug‐related increase in sensitivity toward type 1 helper T cell‐biased haptens . An additional concern is the risk and impact of developing anti‐drug antibodies, an emerging complication of the more well‐established biologic agents …”

The role of dupilumab in managing allergic contact dermatitis

“…A meta-analysis of eight randomized controlled trials that compared dupilumab to a placebo for the treatment of AD found that patients receiving dupilumab had statistically significant increases in the incidences of conjunctivitis (RR 2.64), injectionsite reactions (RR 2.24), and headache (RR 1.47). 28 These effects are not likely due to an immunosuppressive mechanism since this medication has had no known immunosuppressive activity and incidences of nasopharyngitis, upper respiratory infections, urinary tract infections, and herpes virus infections were not increased with dupilumab when compared to placebo. 28,29…”