Dupilumab-induced psoriasis in a patient with atopic dermatitis successfully treated with Upadacitinib: A case report
Abstract
Dupilumab, a monoclonal antibody that targets interleukin-4 and interleukin-13, is one of the approved biologic treatments for moderate-to-severe atopic dermatitis. While it is extremely well tolerated with low rates of adverse events, there have been reports of patients with atopic dermatitis managed on Dupilumab developing new-onset psoriasis. The development of psoriasis in patients with atopic dermatitis on Dupilumab therapy is believed to occur due to a decrease in T helper 2 activity and resultant dysregulation of the T helper 1 and T helper 17 pathways involved in psoriasis pathogenesis. Upadacitinib, an oral, selective Janus kinase 1 inhibitor, approved for use in moderate-to-severe atopic dermatitis as well as psoriatic arthritis may have a potential role in psoriasis treatment. We describe a case of a patient who initially presented with longstanding atopic dermatitis that underwent a psoriasiform switch while managed on Dupilumab and is currently stable on Upadacitinib.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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