Eosinophilic annular erythema treated with dupilumab

Gordon, Samantha; Robinson, Sarah N.; Abudu, Minawaer; Her, Michelle; Deverapalli, Sandyha; Levin, Adrianne; Schmidt, Birgitta; Gellis, Stephen E.; Rosmarin, David

doi:10.1111/pde.13533

Cited by 33 publications

(32 citation statements)

References 4 publications

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“…Suplatast tosilate, an anti-allergic medication that suppresses the production of IgE and synthesis of IL-4 and IL-5, was administered to one patient with EAE, resulting in complete resolution of the lesions within 2 weeks [16]. Dupilumab, an IL-4 receptor alpha antagonist, was also successfully used in a 14-year-old African-American girl with EAE [17].…”

Section: Discussionmentioning

confidence: 99%

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Mepolizumab Therapy for Recalcitrant Eosinophilic Annular Erythema in an Adult: A Case Report and Review of Treatment Options

Żychowska

Tutka

Reich

2020

Dermatol Ther (Heidelb)

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Eosinophilic annular erythema (EAE) is a rare condition with a chronic relapsing and remitting course, characterized by the presence of annular or polycyclic erythematous and plaque lesions and prominent tissue eosinophilia on histopathology. There is an ongoing discussion on whether EAE is a subset of Wells syndrome (eosinophilic cellulitis) or a separate entity. To date, few cases of EAE have been reported in the literature; of these, about 40 cases were in adults and fewer than ten cases were in children. Given the rarity of this condition, there are no clear recommendations for its management.

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Section: Discussionmentioning

confidence: 99%

“…A search of the literature revealed that only about 40 cases of EAE in adults and fewer than 10 cases in children have been reported to date. Among adult patients, a slight female preponderance has been noted (female:male ratio 1.14:1), and age at onset varies from 20 to 85 years [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Mepolizumab Therapy for Recalcitrant Eosinophilic Annular Erythema in an Adult: A Case Report and Review of Treatment Options

Żychowska

Tutka

Reich

2020

Dermatol Ther (Heidelb)

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“…Nonetheless, patients with both atopic dermatitis and alopecia areata treated with dupilumab have repeatedly demonstrated hair regrowth (103–105). Furthermore, some isolated cases were published with beneficial results in bullous pemphigoid (106), eosinophilic annular erythema (107), and papuloerythroderma of Ofuji (108).…”

Section: Discussionmentioning

confidence: 99%

Learning From Success and Failure: Biologics for Non-approved Skin Diseases

2019

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The impressive potential of biologics has been demonstrated in psoriasis, hidradenitis suppurativa, and urticaria. Numerous biologicals are entering the field for a restricted number of skin disorders. Off-label use of biologics in other recalcitrant skin diseases has increased. Mounting data point to the potential of already existing biologics acting on the IL-17/IL-23 pathway in skin disorders with epidermal hyperkeratosis (e.g., pityriasis rubra pilaris), acneiform inflammation (e.g., hidradenitis suppurativa), and loss of mucosal integrity (e.g., aphthosis). TNF-α blockers are also effective in the latter conditions but seem of particular value in granulomatous (e.g., granuloma annulare) and neutrophilic disorders (e.g., pyoderma gangrenosum). Failure of IL-17 blockade in skin diseases resulting from immune-mediated cell destruction (e.g., alopecia areata and vitiligo) illustrates its limited involvement in Th1-dependent skin immunology. Overall, disappointing results of TNF-α blockers in alopecia areata and vitiligo point to the same conclusion although promising results in toxic epidermal necrolysis suggest TNF-α exerts at least some in vivo Th1-related activities. Acting on both the Th1 and Th17 pathway, ustekinumab has a rather broad potential with interesting results in lupus and alopecia areata. The efficacy of omalizumab in bullous pemphigoid has revealed an IgE-mediated recruitment of eosinophils leading to bullae formation. Reconsidering reimbursement criteria for less common but severe diseases seems appropriate if substantial evidence is available (e.g., pityriasis rubra pilaris). For other disorders, investigator-and industry-initiated randomized clinical trials should be stimulated. They are likely to improve patient outcome and advance our understanding of challenging skin disorders.

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“…Es ist charakterisiert durch rezidivierende, anuläre, erytheamtös‐ödematöse, pruritische Erytheme mit Gewebseosinophilie. Im Gegensatz zum Well's Syndrom zeigen sich meist weder eine periphere Eosinophilie noch ”flame figures” oder granulomatöse Strukturen in der Histologie[1]. Aktuelle Therapieoptionen beinhalten systemische Steroide, Dapson und Hydroxychlorquin, wobei das EAE sich häufig therapierefraktär zeigt und zu Rezidiven neigt [2–4].…”

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