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Skin Diseases and Disorders

Skin Diseases and Disorders

Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...

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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

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Published on: July 11, 2013

Psoriasis Risk in Patients With Atopic Dermatitis Treated With Dupilumab.

Teng-Li Lin^1,2, Yi-Hsuan Fan³, Kuo-Sheng Fan⁴

¹Department of Dermatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.

JAMA Dermatology

|June 18, 2025

Summary

Patients with atopic dermatitis (AD) treated with dupilumab showed a higher risk of developing psoriasis compared to other systemic agents. However, the absolute risk is low, requiring a balance with dupilumab

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Area of Science:

Dermatology
Immunology
Pharmacovigilance

Background:

Patients with atopic dermatitis (AD) have anecdotally been reported to develop psoriasis during dupilumab treatment.
The association between dupilumab and new-onset psoriasis requires further investigation to distinguish true association from incidental occurrence.

Purpose of the Study:

To compare the risk of incident psoriasis in adult patients with AD treated with dupilumab versus other systemic agents.
To evaluate the association between dupilumab use and psoriasis development in a large, real-world population.

Main Methods:

A population-based retrospective cohort study utilizing the TriNetX Global Collaborative Network.
Propensity score matching (1:1 ratio) was employed to compare patients newly prescribed dupilumab with those on alternative systemic therapies (corticosteroids, methotrexate, cyclosporine, azathioprine, mycophenolate mofetil).
A 3-year follow-up period was used to assess the cumulative incidence and risk of incident psoriasis.

Main Results:

The 3-year cumulative incidence of psoriasis was significantly higher in the dupilumab cohort (2.86%) compared to the control cohort (1.79%; P < .001).
Dupilumab use was associated with an increased risk of psoriasis (Hazard Ratio [HR], 1.58; 95% Confidence Interval [CI], 1.25-1.99).
The number needed to harm for psoriasis was 94, and the increased risk was observed across various AD subgroups and in patients with asthma without AD.

Conclusions:

This study suggests a higher relative risk of developing psoriasis in patients with AD treated with dupilumab compared to other systemic agents.
The absolute risk of psoriasis associated with dupilumab appears limited (Number Needed to Harm = 94).
The findings necessitate careful consideration of the established efficacy of dupilumab against its potential risk of inducing psoriasis in AD patients.