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Una reacción inesperada a dupilumab
Gabriela E Beraja1, Connor J Stonesifer1, Danyelle M Dawes1
1Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA.
Cureus
|February 4, 2026
Resumen
La sarna costrosa (SC) puede ocurrir en pacientes tratados con dupilumab. Este caso destaca la necesidad de un tratamiento prolongado con ivermectina para la resolución completa en tales casos.
Área de la Ciencia:
- Dermatología
- Inmunología
- Parasitología
Sus antecedentes:
- La sarna costrosa (SC) es una forma grave y contagiosa de sarna caracterizada por la proliferación extensa de ácaros en la piel.
- El diagnóstico de SC puede ser un desafío debido a su similitud con los trastornos hiperqueratósicos.
- Las terapias biológicas se han asociado con la SC, y algunos casos se resuelven con ivermectina.
Objetivo del estudio:
- Informar un caso de sarna costrosa en un paciente en tratamiento con dupilumab.
- Investigar el papel potencial de dupilumab en el desarrollo de SC.
- Destacar el curso del tratamiento y los resultados de la SC en pacientes con dupilumab.
Principales métodos:
- Informe de caso de un paciente con SC mientras recibía dupilumab.
- Revisión de la literatura previa sobre SC y terapias biológicas.
- Análisis de la respuesta al tratamiento con un régimen prolongado de ivermectina.
Principales resultados:
- El paciente con SC en dupilumab requirió un régimen de ivermectina extendido de siete días para la resolución completa.
- Esto contrasta con informes anteriores de resolución rápida en casos similares.
- La supresión de Th2 por dupilumab puede contribuir a la proliferación incontrolada de ácaros.
Conclusiones:
- La terapia con dupilumab puede aumentar el riesgo de infecciones escabióticas persistentes.
- Puede ser necesario un tratamiento prolongado contra la sarna para la SC en pacientes con dupilumab.
- Se necesita más investigación sobre los mecanismos inmunológicos de la SC en pacientes inmunocomprometidos.
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