Atopic dermatitis exacerbated with ustekinumab in a psoriatic patient with childhood history of atopy

Lis‐Święty, Anna; Skrzypek‐Salamon, Alina; Arasiewicz, Hubert; Brzeźińska-Wcisło, Ligia

doi:10.1016/j.alit.2015.06.003

Cited by 23 publications

(16 citation statements)

References 9 publications

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“…Its efficacy has been shown even for psoriatic patients with high total serum IgE levels and, indeed, UST lowered the number of IgE‐ and FcεRI‐bearing cells in the lesional skin . However, previous case reports have also documented that UST provoked or exacerbated AD‐like symptoms paradoxically while improving psoriatic symptoms . We also experienced a similar reciprocal phenomenon following UST administration in a couple of psoriatic patients.…”

Section: Discussionsupporting

confidence: 70%

Exacerbation of atopic dermatitis symptoms by ustekinumab in psoriatic patients with elevated serum immunoglobulin E levels: Report of two cases

Ishiuji

Umezawa

Asahina

et al. 2018

The Journal of Dermatology

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Psoriasis is a chronic inflammatory skin disease mainly mediated by a T-helper cell subset, Th17 cells. Recently, increased levels of total serum immunoglobulin (Ig)E have been reported in a subset of psoriatic patients. Ustekinumab (UST) is one of the most commonly used biologic agents for the treatment of moderate to severe plaque psoriasis, and a previous report also documented effectiveness of UST for psoriatic patients with high serum IgE levels. We experienced two psoriatic patients with high serum IgE levels, in whom UST completely improved psoriasis but paradoxically provoked or exacerbated atopic dermatitis (AD)-like symptoms. This reciprocal phenomenon suggests the shift of Th balance toward Th2, along with altered profiles of inflammatory cytokines. It appears prudent to consider the possibility of such adverse effects when treating psoriatic patients with UST with concomitant AD symptoms, a history of AD or high serum IgE levels.

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Section: Discussionsupporting

confidence: 70%

Exacerbation of atopic dermatitis symptoms by ustekinumab in psoriatic patients with elevated serum immunoglobulin E levels: Report of two cases

Ishiuji

Umezawa

Asahina

et al. 2018

The Journal of Dermatology

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“…One of the patients had a history of atopic dermatitis, and both had high levels of IgE (6). In the patient with a history of atopic dermatitis during early childhood, psoriatic eruptions were relieved by administration of ustekinumab; however, his atopic dermatitis relapsed and worsened (7). Atopic dermatitis-like eruptions have been reported to be caused by various biologics used for the treatment of psoriasis.…”

Section: Discussionmentioning

confidence: 99%

Atopic Dermatitis-like Eruption Induced by Two Different Biologics in a Patient with Psoriatic Arthritis

Abe

Mitsuyama²,

Nagao³

et al. 2019

Acta Derm Venereol

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“…In this trial, dosing of ustekinumab followed the recommendations for psoriasis, namely 45 and 90 mg per injection for patients weighing ≤100 or >100 kg, respectively, and the authors also observed that ustekinumab could determine a significant modulation of Th1, Th17 and Th22 and Th2-related AD genes after 4 weeks of treatment (i.e., MMP12, IL-22, IL-13, IFN-γ, elafin/PI3, CXCL1, CCL17) [102]. In addition, other authors reported inadequate response to ustekinumab treatment in two adult AD patients even if with the addition of aggressive topical corticosteroid therapy, whereas Lis-Święty et al observed an exacerbation of AD under ustekinumab therapy in a psoriatic patient with a childhood history of atopy [103, 104]. In summary, data regarding ustekinumab efficacy in adult AD are controversial and scant, with the only existing double-blind placebo-controlled study lacking evidence of statistically significant efficacy.…”

Section: Methodsmentioning

confidence: 99%

Systemic Treatment of Adult Atopic Dermatitis: A Review

Megna

Napolitano

Patruno

et al. 2016

Dermatol Ther (Heidelb)

133

109

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Atopic dermatitis (AD) is a common chronic inflammatory skin disease that predominantly affects children. However, it can persist in adulthood and/or start at older ages. Due to its chronic nature and frequently occurring relapses, AD has a substantial effect on patients' quality of life, often requiring long-term systemic treatment, especially in adult patients, who are more frequently refractory to adequate topical treatment with mid- to high-potent corticosteroids and/or calcineurin inhibitors. Therefore, treatment with systemic therapies is often needed to take control of the disease, prevent exacerbations and improve quality of life. However, data regarding systemic treatment effectiveness and long-term safety in adult patients with AD are insufficient. Indeed, standardized international guidelines are lacking, and the treatment approach widely differs among diverse countries. This review focuses on the use of systemic treatments in adult AD patients analyzing published literature.

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Atopic dermatitis exacerbated with ustekinumab in a psoriatic patient with childhood history of atopy

Cited by 23 publications

References 9 publications

Exacerbation of atopic dermatitis symptoms by ustekinumab in psoriatic patients with elevated serum immunoglobulin E levels: Report of two cases

Exacerbation of atopic dermatitis symptoms by ustekinumab in psoriatic patients with elevated serum immunoglobulin E levels: Report of two cases

Atopic Dermatitis-like Eruption Induced by Two Different Biologics in a Patient with Psoriatic Arthritis

Systemic Treatment of Adult Atopic Dermatitis: A Review

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