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

SAGE Open Medical Case Reports
Ho Seung Kim, Jensen Yeung

Abstract

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.

References

Jun 26, 2001·Clinical and Experimental Dermatology·E Christophers
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Sep 10, 2017·The Journal of Allergy and Clinical Immunology·Jason E HawkesJames G Krueger
Sep 22, 2018·Dermatologic Therapy·Martina BurlandoAurora Parodi
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Sep 11, 2019·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·Hani Harb, Talal A Chatila
Feb 26, 2020·JAAD Case Reports·Aakaash Varma, Jacob Levitt

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Citations

Nov 25, 2020·Journal of the European Academy of Dermatology and Venereology : JEADV·L JaulentUNKNOWN for GREAT Research Group
Nov 2, 2021·Expert Review of Clinical Immunology·Giuseppe IngrasciGil Yosipovitch

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Methods Mentioned

BETA
biopsy
biopsies

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Atopic Dermatitis

Atopic dermatitis is a chronic inflammatory genetically determined disease of the skin marked by increased ability to form reagin (IgE), with increased susceptibility to allergic rhinitis and asthma, and hereditary disposition to a lowered threshold for pruritus. Discover the latest research on atopic dermatitis here.

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