Psoriasis-like Eruption triggered by Dupilumab Therapy

Russo, Filomena; Provvidenziale, Luca; Bruzziches, Francesco; Fiorani, Diletta; Santi, Francesco; Lamberti, Arianna; Lazzeri, Laura; Flori, Maria Laura; Rubegni, Pietro

doi:10.1097/der.0000000000000740

Cited by 18 publications

(14 citation statements)

References 4 publications

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“…IL-4 is a negative regulator of Th1 and Th17 cells and dupilumab can drive a shift towards a Th1/Th17 phenotype, thereby resulting in an inflammatory cytokine cascade and eventually psoriatic skin plaques. 6,7 However, interestingly, dupilumab improved the conditions in our patient, and there were no complaints of discomfort. IL-4 acts directly on T cells, dendritic cells, and keratinocytes.…”

mentioning

confidence: 47%

Successful treatment of secukinumab‐resistant palmoplantar pustulosis by Dupilumab: A case report

Zheng

Min

Cai

2022

Dermatologic Therapy

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mentioning

confidence: 47%

Successful treatment of secukinumab‐resistant palmoplantar pustulosis by Dupilumab: A case report

Zheng

Min

Cai

2022

Dermatologic Therapy

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“…An imbalance between Th1/Th17 and Th2 pathways has been proposed in the pathogenesis of psoriasis during dupilumab treatment 25 . Even if this cAE was not reported in the clinical trials for dupilumab, postapproval reports of new or worsening psoriasis developing in patients while taking dupilumab treatment have been increasing 26–30 . In our study population, 4.25% (39 of 916) of patients showed psoriasis during therapy with dupilumab, and about a quarter of them (10 of 39; 25.64%) had to stop the drug.…”

Section: Discussionmentioning

confidence: 72%

“…25 Even if this cAE was not reported in the clinical trials for dupilumab, postapproval reports of new or worsening psoriasis developing in patients while taking dupilumab treatment have been increasing. [26][27][28][29][30] In our study population, 4.25% (39 of 916) of patients showed psoriasis during therapy with dupilumab, and about a quarter of them (10 of 39; 25.64%) had to stop the drug. The exact immunologic mechanism through which dupilumab induces the development of psoriasis remains unclear.…”

Section: Discussionmentioning

confidence: 74%

Dupilumab‐associated cutaneous adverse events among adult patients with atopic dermatitis: A retrospective study

Napolitano

Fabbrocini

Patruno

2023

The Journal of Dermatology

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Dupilumab, a monoclonal antibody inhibiting interleukin (IL) 4 and IL‐13, is approved for the treatment of moderate to severe atopic dermatitis (AD) in children aged ≥6 years, adolescents, and adults. Both clinical trials and real‐life data demonstrate its efficacy and safety. However, some cutaneous adverse events (cAEs) have been observed during real‐world experiences. The authors’ aim was to analyze the spectrum of cAEs in patients receiving dupilumab for the treatment of AD in a real‐world setting. A retrospective review of electronic medical records was conducted for 916 patients (475 males and 541 females; mean age, 50.23 ± 19.66 years [range, 18–91 years]) who had received dupilumab for a minimum of 1 month for the treatment of AD from December 2018 to November 2022 at the Department of Dermatology of University Federico II of Naples (Italy). The mean duration of dupilumab treatment was 27.31 ± 21.26 months. A total of 148 of 916 (16.15%) (90 males; mean age, 50.91 ± 15.34 years) patients reported other cAEs apart of AD flare; namely, facial redness (82 of 916; 8.95%), psoriasis (39 of 916; 4.25%), alopecia areata (11 of 916; 1.2%), skin peeling (11 of 916; 1.2%), parapsoriasis (three of 916; 0.32%), and vitiligo (two of 916; 0.21%). Thirty‐one of 916 (3.38%) patients discontinued dupilumab because of cAEs (18 of 916; 1.96%) for facial redness, 10 of 916 (1.09%) for psoriasis, and three of 916 (0.32%) for parapsoriasis. In our population, most of the cAEs were mild and did not require discontinuation of dupilumab. These findings would enable dermatologists understand the cutaneous side effects of dupilumab better, resulting in improved treatment plan decisions in clinical practice.

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“…The cause was suggested to be the imbalance of Th2/Th22 response to anti-IL-17A drugs by blocking the Th1/Th17 pathway. Filomena Russo et al [15] reported a case of psoriasis during treatment of PN with dupilumab (IL-4 inhibitor) due to a Th1/Th17 imbalance. In this particular case, the patient developed PN after treatment with an IL-17A inhibitor for 2 months, excluding food allergy and contact dermatitis.…”

Section: Discussionmentioning

confidence: 99%

Prurigo Nodularis Onset during IL-17A Inhibitor Treatment of Psoriasis: A Case Report

Lyu

Gui

et al. 2022

Preprint

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Background: secukinumab has been approved by the U.S. FDA and the European Medicines Agency for the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis. Here we report a case of prurigo nodularis during the treatment of psoriasis with secukinumab, which has never been reported before. Case introduction: the patient was a 22-years-old male with a 6-month history of severe plaque paoriasis vulgaris, who received regular treatment with satisfactory control of the psoriatic rash, and was seen for 1 week for red papules and nodules with pruritus on the trunk and extremities. Dermatologic condition: multiple edematous red firm papules on the trunk and extremities in the form of soy or hemispherical nodules, with some tops visible as ulcerated crusts, red in color, firm to touch, and negative Auspitz sign. Pathological examination confirmed prurigo nodularis (PN). Conclusion: This case is shared to inform clinicians about yet another adverse effect of the IL-17A inhibitor in the treatment of psoriasis. It is recommended that patients be carefully informed of the possible risk of prurigo nudularis before starting treatment.

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Psoriasis-like Eruption triggered by Dupilumab Therapy

Cited by 18 publications

References 4 publications

Successful treatment of secukinumab‐resistant palmoplantar pustulosis by Dupilumab: A case report

Successful treatment of secukinumab‐resistant palmoplantar pustulosis by Dupilumab: A case report

Dupilumab‐associated cutaneous adverse events among adult patients with atopic dermatitis: A retrospective study

Prurigo Nodularis Onset during IL-17A Inhibitor Treatment of Psoriasis: A Case Report

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