AI Article Synopsis
- This report explores the occurrence of psoriasiform eruptions in children treated with dupilumab for atopic dermatitis, highlighting a previously noted risk in adults.
- A review of cases showed that six children, aged 4-18, developed new psoriasiform dermatitis after an average of 8 months on dupilumab, primarily affecting common psoriasis locations.
- Most patients responded well to topical corticosteroids while continuing dupilumab, although one child experienced unmasked psoriasis due to inadequate response to the treatment.
Article Abstract
Background/objectives: Psoriasiform eruptions after initiation of dupilumab have been previously described in adults. This report details the risk of developing or unmasking psoriasiform eruptions after initiation of dupilumab in children.
Methods: Records of patients ≤18 years of age with atopic dermatitis who developed psoriasiform dermatitis during treatment with dupilumab were reviewed retrospectively.
Results: Six children, 4-18 years of age, on dupilumab for severe atopic dermatitis developed new-onset psoriasiform dermatitis at a median duration of 8 months (range, 6-12 months) after dupilumab initiation. Typical locations of psoriasis were involved (face, scalp, trunk, and extensor extremities). The majority showed clearance or near clearance with the use of medium-strength to potent topical corticosteroid ointments and 83% continued use of the dupilumab. A 7th patient had psoriasis, in addition to severe atopic dermatitis, and the psoriasis was unmasked by its failure to respond to dupilumab.
Conclusion: Although unusual, psoriasiform lesions can appear during effective treatment with dupilumab for atopic dermatitis, potentially reflecting a shift toward cutaneous IL-23/T 17 pathway activation with dupilumab-induced suppression of type 2 immunity.
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| http://dx.doi.org/10.1111/pde.14820 | DOI Listing |
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