Comment on: Development of psoriasis during treatment with dupilumab: A systematic review

Cohen, Jeffrey M.; Damsky, William

doi:10.1016/j.jaad.2021.06.893

Cited by 6 publications

(6 citation statements)

References 4 publications

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“…Although it has not been indicated for the treatment of psoriasis, this monoclonal antibody may be associated with psoriasis or psoriasiform dermatitis in patients with atopic dermatitis. This type of psoriasis appears to be immunologically distinct from classical psoriasis, and some cases were described as ‘‘psoriasiform’’ because they did not necessarily meet the definition of psoriasis [ 66 , 67 , 68 , 69 , 70 ]. Although a switch in the polarization of the predominant immune response from Th 2 to Th 17 was hypothesized, a deeper understanding of the mechanism behind this reaction to dupilumab will lead to the complete comprehension of the immunopathogeneses of psoriasis and atopic dermatitis [ 71 ].…”

Section: Psoriasis Biologics and Skin Patch Testingmentioning

confidence: 99%

Allergic Contact Cell-Mediated Hypersensitivity in Psoriasis: A Narrative Minireview

et al. 2022

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The dysfunctionality of the protective skin barrier in psoriasis allows easier cutaneous penetration of various contact haptens; thus, such patients can develop allergic contact hypersensitivity as a comorbidity. Both skin conditions involve T-cell-mediated mechanisms. Dermatologists and allergists should consider assessing allergic contact cell-mediated hypersensitivity in selected psoriasis patients, especially those with palmoplantar psoriasis and who are refractory to topical treatments, and in patients with psoriasis, with or without arthritis, treated with biologics that present skin lesions clinically suggestive of contact dermatitis.

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Section: Psoriasis Biologics and Skin Patch Testingmentioning

confidence: 99%

Allergic Contact Cell-Mediated Hypersensitivity in Psoriasis: A Narrative Minireview

et al. 2022

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“…5 Studies have shown that dupilumab treatment of AD patients may result in the development of psoriasis via Th2 blockade, resulting in the conversion of Th2 cells into Th1 and Th17 cells. 6,7 Reverse psoriasis has the same immunological mechanism as conventional psoriasis 8 ; the above theory can also be used to explain the mechanism underlying the development of reverse psoriasis during dupilumab treatment in our patient.…”

mentioning

confidence: 76%

A case of dupilumab‐induced reverse psoriasis in a patient with atopic dermatitis

Fan

Zhang

et al. 2022

Dermatologic Therapy

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“…[ 33 34 ] Cytokine RNA in situ hybridisation was conducted to demonstrate an association between dupilumab therapy and newly developed P-PRs by some researchers, showing de novo IL-17A, reduced IL-13 and IL-4 and increased IL-23A expression in the biopsy of psoriasiform eruptions induced by dupilumab. [ 35 36 37 ] Researchers quantified the expression of various cytokines on biopsy specimens, which would be a promising method for the diagnosis of dupilumab-induced psoriasis.…”

Section: Discussionmentioning

confidence: 99%

Biologics-Induced Immunophenotypic Cross-Switching in Patients with Psoriasis and Atopic Dermatitis

Liu

Zhang

2023

Indian Journal of Dermatology

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Antibody-based therapies that inhibit pro-inflammatory cytokine signalling are commonly used in dermatology. Paradoxically, these biological agents may induce or exacerbate paradoxical reactions. Recently, it has been reported that the treatment of eczema with dupilumab can lead to the development of psoriasiform eruptions, which we called psoriasiform paradoxical reactions (P-PRs). Conversely, cases of eczematous paradoxical reactions (E-PRs) have also been described in patients with psoriasis treated with biologics. To summarise the case characteristics and disease features of phenotypic transition between psoriasis and eczematoid dermatitis, and to explore the mechanism or connection related to biological agents or patients’ genetic characteristics, a systematic review was conducted for P-PRs in atopic dermatitis and E-PRs in patients with psoriasis treated with corresponding biological agents, respectively. We identified a series of P-PRs in 42 atopic dermatitis cases treated with dupilumab. The time to onset of P-PRs typically ranged from weeks to months, with a mean latency period of 22.65 weeks. Almost all patients presented with new-onset P-PRs. Simultaneously, we reviewed 22 articles reporting 51 patients with psoriasis with biological agent-induced E-PRs, which occurred on average at 24.47 weeks, 72.55% of them induced by IL-17A inhibitors. 48.98% (24/49) of cases reported a positive personal history of atopy, which may suggest an increased risk of biological agent-induced paradoxical eruptions. Overall, the improvement or resolution upon discontinuation of the inciting biologics was relatively common, and further studies are needed to estimate the real prevalence and unveil the pathophysiological mechanisms of these paradoxical events.

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Comment on: Development of psoriasis during treatment with dupilumab: A systematic review

Cited by 6 publications

References 4 publications

Allergic Contact Cell-Mediated Hypersensitivity in Psoriasis: A Narrative Minireview

Allergic Contact Cell-Mediated Hypersensitivity in Psoriasis: A Narrative Minireview

A case of dupilumab‐induced reverse psoriasis in a patient with atopic dermatitis

Biologics-Induced Immunophenotypic Cross-Switching in Patients with Psoriasis and Atopic Dermatitis

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