Case Series: Scabies Complicating Dupilumab Therapy for Atopic Dermatitis

Area of Science:

• Dermatology
• Immunology
• Infectious Diseases

Background:

• Atopic dermatitis is an inflammatory skin condition.
• Dupilumab is a biologic treatment targeting the Type 2 immune response.
• Scabies is a parasitic skin infestation.
• Type 2 immune response plays a role in scabies pathogenesis.

Purpose of the Study:

• To report a case series of patients developing scabies during Dupilumab therapy.
• To explore the potential link between Dupilumab's mechanism of action and scabies presentation.
• To raise clinical awareness regarding scabies in patients treated with Dupilumab.

Main Methods:

• Case series presentation.
• Review of clinical data for four patients with atopic dermatitis on Dupilumab who developed scabies.
• Analysis of the immunological pathway targeted by Dupilumab and its potential impact on scabies.

Main Results:

• Four patients on Dupilumab for atopic dermatitis were diagnosed with scabies.
• Scabies presentations included treatment resistance and crusted forms.
• The mechanism of Dupilumab inhibiting the Type 2 immune response may contribute to these findings.

Conclusions:

• Dupilumab treatment may be associated with the development of scabies.
• Inhibition of the Type 2 immune response by Dupilumab could influence scabies presentation and treatment response.
• Clinicians should consider scabies in patients on Dupilumab, especially with atypical or resistant presentations, and be aware of potential misdiagnosis as atopic dermatitis.