An Isolated Cutaneous Nodule: Dupilumab-Induced Sarcoid-Like Reaction.

Area of Science:

• Dermatology
• Immunology
• Rheumatology

Background:

• Dupilumab is increasingly used for atopic dermatitis and other inflammatory conditions.
• Drug-induced sarcoid-like reactions (DISR) are an emerging concern with dupilumab.
• Early identification of DISR is crucial for patient management.

Observation:

• A patient developed a solitary skin nodule after starting dupilumab.
• Histopathology and MRI confirmed the nodule was a sarcoid granuloma.
• The lesion resolved six months after discontinuing dupilumab.

Findings:

• Dupilumab can trigger sarcoid-like reactions, specifically cutaneous granulomas.
• This case highlights a potential autoimmune response to dupilumab.
• Resolution of symptoms upon drug cessation supports a causal link.

Implications:

• Increased dupilumab use may lead to more DISR cases.
• Clinicians should consider DISR in patients on dupilumab presenting with granulomatous lesions.
• Prompt diagnosis and management, including drug discontinuation, are key.