Dupilumab-Induced Psoriasiform Eruption in an 83-Year-Old Patient

This case report describes an 83-year-old female who developed severe psoriasiform lesions suspected to be induced by dupilumab. The patient initially presented with eczematous papules affecting her back, arms, torso, and scalp, and a biopsy confirmed a subacute eczematous process. Treatment with topical, intralesional, and oral steroids failed to show significant improvement. Given the recalcitrant nature of her dermatitis, she was started on dupilumab injections, which initially offered temporary resolution and regression of her existing lesions. However, two weeks after initiating dupilumab treatment, the patient's lesions relapsed and progressively worsened. A repeat biopsy at this time showed psoriasiform epidermal hyperplasia, and dupilumab treatment was stopped. The patient was ultimately transitioned to secukinumab, an IL-17 inhibitor, which resolved her flare.