Dupilumab for the treatment of recalcitrant eosinophilic dermatosis of haematologic malignancy

Maglie, Roberto; Ugolini, Filippo; Logu, Francesco De; Simi, Sara; Senatore, Stefano; Montefusco, Francesca; Nassini, Romina; Massi, Daniela; Antiga, Emiliano

doi:10.1111/jdv.17232

Cited by 16 publications

(4 citation statements)

References 9 publications

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“…In two of the reported patients, strikingly, no eosinophilia was found in the blood. All four patients reported rapid complete clearance of skin manifestations within 4–6 weeks ( Table 7 ) [ 8 , 218 , 219 , 220 ].…”

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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Section: Resultsmentioning

confidence: 99%

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

et al. 2023

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“…Our study found no excess of serum levels of IL-4 and IL-5, which play a role, respectively, in type 2 immune responses and eosinophil regulation (29), however, these interleukin levels were not tested in skin lesions, which is a limitation of the study. Few anecdotal reports of the use of monoclonal antibody blocking IL-4 and IL-13 (Dupilumab) in the treatment of EDHM show discordant outcomes that neither confirm nor contradict the possible role of IL-4 (47)(48)(49)(50).…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic dermatosis of hematologic malignancy in patients with chronic lymphocytic leukemia/non-Hodgkin’s B lymphoma: a single center prospective clinico-pathological study

et al. 2023

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BackgroundThe pathogenesis of eosinophilic dermatosis of hematologic malignancy (EDHM) is poorly understood. Previously thought to be a hypersensitivity reaction to insect bites, immune dysregulation and cytokine imbalance are now thought to be responsible. Its prognostic significance is unclear.ObjectiveTo describe the clinical, pathological and immunological findings in a series of oncohematological patients with EDHM.MethodsAn observational prospective cohort study of oncohematological patients receiving a diagnosis of EDHM between April 2017 and December 2018.ResultsA total of 15 patients with EDHM (10 females and 5 males) were identified among 422 oncohematological patients. Disease presentation varied from firm erythematous papules to more polymorphic presentations. The lesions were most prevalent on the exposed sites, 8/15 patients recalled an insect bite. Lesion seasonality was reported in 13/15 patients. IgE levels were elevated in six patients, circulating IL-4 and IL-5 were within a normal range. Twelve out of 15 patients developed skin manifestations after chemotherapy. The infiltrate could be eosinophil-rich or lymphocytic-rich. Interestingly, the histopathologic findings were in accordance with arthropod bites.ConclusionA role for insect bites in EDHM is supported by our findings. EDHM may be related to aggressive hematologic disease.

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“…However, this was the only result we found regarding cancer development during Dupilumab treatment (other than T-cell lymphomas, see section “Dupilumab and T-cell lymphomas”), so it is safe to say that this is most likely an isolated incident, with no link to the drug. Favorable outcomes have also been reported for patients with haematologic malignancy [ 26 , 27 , 28 ]. The results are summarized in Table 4 .…”

Section: Discussionmentioning

confidence: 99%

Atopic Dermatitis with Multiple Comorbidities Treated with Dupilumab. A Case Report and Review of the Literature Regarding the Safety of Dupilumab

Mitroi

Stoica

Mitroi

et al. 2022

Life

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Dupilumab is the only available biological treatment for moderate-to-severe atopic dermatitis (AD). Even so, limited clinical data regarding its safety profile are available. Interactions with other drugs and the adverse effects of Dupilumab on patients with multiple comorbidities, such as chronic heart disease, diabetes, chronic kidney disease, etc., are not known yet. Moreover, there have been described cases of cutaneous lymphomas induced by Dupilumab. Therefore, the clinician that wants to start treatment for moderate-to-severe atopic dermatitis, which does not respond to conventional drugs, might be reluctant to choose biologic agents such as Dupilumab. In this paper, we reported a case of severe atopic dermatitis with multiple comorbidities in which the patient was successfully treated with Dupilumab despite numerous underlying conditions. We also conducted a review of the current literature on the safety profile of Dupilumab in special categories of patients with comorbidities, such as heart, kidney, and liver disease, oncologic conditions, and during pregnancy.

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Dupilumab for the treatment of recalcitrant eosinophilic dermatosis of haematologic malignancy

Cited by 16 publications

References 9 publications

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

Eosinophilic dermatosis of hematologic malignancy in patients with chronic lymphocytic leukemia/non-Hodgkin’s B lymphoma: a single center prospective clinico-pathological study

Atopic Dermatitis with Multiple Comorbidities Treated with Dupilumab. A Case Report and Review of the Literature Regarding the Safety of Dupilumab

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