Psoriasis appearing after dupilumab therapy in atopic dermatitis: A case report

Abstract

<jats:p> A 36-year-old Caucasian female with a long history of atopic dermatitis presented with multiple flares eventually leading to dupilumab therapy. Five months into the dupilumab therapy, she presented with well-demarcated erythematous plaques with silvery scale resembling psoriasis on her knees and shins (body surface area 2%, Psoriasis Area Severity Index 1.6, Investigator’ Global Assessment 2). Biopsies were taken to confirm the diagnosis of classic psoriasis. Dupilumab was continued for another month while using clobetasol 0.05% ointment. The patient reported poor adherence to clobetasol therapy, and the lesions persisted. When dupilumab was discontinued, her psoriasis resolved over 6 weeks, but her atopic dermatitis returned. Dupilumab was restarted for atopic dermatitis management, and her psoriasis returned. There appears to be a rare causal association between dupilumab and psoriasis in this case. The mechanism of the drug reaction is yet to be discovered. </jats:p>

De novo psoriasis in atopic dermatitis patients treated with dupilumab: a retrospective cohort

“…L. Jaulent, 1 D. Staumont-Sall e, 2 M. Tauber, 3 C. Paul, 3 H. Aubert, 4 A. Marchetti, 5 B. Sassolas, 6 A. Valois, 7 J.-F. Nicolas, 1,8 A. Nosbaum, 1,8,* for GREAT Research Group 1 Allergy and Clinical Immunology Department, Univ Lyon, Lyon Sud…”

Practical Management of Patients with Atopic Dermatitis on Dupilumab

“…Paradoxical psoriasiform eruption has been described in a small number of cases of patients taking dupilumab for AD in adults [ 87 – 92 , 114 – 118 ]. Localization was typically limited to extremities, although other locations were described.…”

“…Approximately half of patients were kept on therapy despite this reaction, with control achieved in most cases with TCS with or without vitamin D analogue. Among those who discontinued therapy, some reports noted resolution of PsO upon dupilumab discontinuation accompanied by eventual AD flare [ 92 , 114 ].…”

Traditional Chinese medicine for food allergy and eczema

“…Dupilumab, an IL-4 and IL-13 receptor blockade, is costly, and psoriasis has been observed as a rare adverse effect. 15 Crisaborole is only recommended for mild-to-moderate disorders. 16 Thus, AD currently represents an important unmet health care need.…”