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Rosacea associated with dupilumab therapy
Haley D Heibel1, Aleksi J Hendricks2, James P Foshee3
1School of Medicine, Creighton University, Omaha, NE, USA.
The Journal of Dermatological Treatment
|May 29, 2019
Summary
Dupilumab, used for atopic dermatitis, may trigger rosacea flares by affecting the Th2 pathway. Discontinuation of dupilumab led to rosacea resolution in a case study.
Area of Science:
- Dermatology
- Immunology
Background:
- Dupilumab targets the interleukin-4 (IL-4) and IL-13 signaling of the T-helper cell type 2 (Th2) pathway.
- Atopic dermatitis (AD) is a chronic inflammatory skin condition.
- Previous reports noted adverse skin reactions to dupilumab, including alopecia and psoriasis.
Observation:
- A 67-year-old female patient with atopic dermatitis experienced recurrent rosacea flares.
- These rosacea flares were temporally associated with dupilumab injections.
- The patient's rosacea symptoms resolved after discontinuing dupilumab therapy.
Findings:
- The study presents a case report of dupilumab-associated rosacea.
- The exact mechanism linking dupilumab to rosacea remains unknown.
- Hypothesized mechanisms include increased Demodex proliferation and T-helper cell type 17 (Th17) inflammation due to Th2 pathway inhibition.
Implications:
- This case suggests a potential link between dupilumab and rosacea development or exacerbation.
- Further research is needed to elucidate the immunologic mechanisms involved.
- Clinicians should be aware of potential rosacea-like reactions in patients treated with dupilumab.
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