Dupilumab
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Psoriatic erythroderma: case report A 59-year-old man developed psoriatic erythroderma during treatment with dupilumab for atopic dermatitis (AD). The man’s medical history was notable for allergic asthma and AD, inadequately controlled by unspecified topical medications. He subsequently started receiving dupilumab [route and dosage not stated]. However, after receiving three standard doses of dupilumab, his skin condition significantly deteriorated. Therefore, dupilumab was discontinued. The man presented to hospital with chills, malaise and severe pruritus. He stated that his skin lesions became more prominent and scaly on the extensor sites of extremities over the weeks prior to presentation. Examination revealed generalised lymphadenopathy and massive erythroderma with largely scaling plaques, mainly on his extremities. Examination of the hair, nails and mucous membranes did not reveal any significant findings. Morphological findings of the skin lesions indicated psoriasis; however, he did not have a personal or family history of psoriasis. Laboratory analyses revealed elevated eosinophils, CRP and total IgE. Skin biopsy showed decreased granular layer and focal parakeratosis with psoriasiform hyperplasia and perivascular lymphocytic infiltrates in the dermis. Based on the clinical, laboratory and histological findings, he was diagnosed with dupilumab-induced psoriatic erythroderma. Further analyses were performed, which showed characteristic cytokine and antimicrobial peptide (AMP) mRNA expression pattern [outcome not stated]. Gambichler T, et al. Dupilumab-induced psoriatic erythroderma with characteristic cytokine and antimicrobial peptide expression pattern in a patient with long standing atopic 803501656 dermatitis. International Journal of Dermatology 59: 1160-1162, No. 9, Sep 2020. Available from: URL: http://doi.org/10.1111/ijd.15003
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Reactions 19 Sep 2020 No. 1822
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