Rosacea associated with dupilumab therapy

Abstract

Background: Dupilumab is used for treatment of atopic dermatitis through blockade of IL-4 and IL-13 signaling of the Th2 pathway. Recent case reports have described alopecia, psoriasis, persistent facial dermatitis, and recall dermatitis at patch test sites after the initiation of dupilumab therapy.

Case report: We describe the case of a 67-year-old female with atopic dermatitis who developed recurrent episodic flares of rosacea temporally associated with dupilumab injections that resolved after dupilumab discontinuation.

Conclusion: The cause of rosacea-like reaction associated with dupilumab treatment is unknown. Th2 pathway inhibition by dupilumab may promote Demodex proliferation and increased IL-17-mediated inflammation implicated in the pathophysiology of rosacea.

Abbreviations: atopic dermatitis: AD; interleukin: IL; persistent facial dermatitis: PFD; T-helper cell type 1: Th1; T-helper cell type 2: Th2; T-helper cell type 17: Th17; tumor necrosis factor-∝: TNF-∝

Keywords:

• Dupilumab
• atopic dermatitis
• rosacea

Disclosure statement

VYS is a stock shareholder of Learn Health and has received honoraria, research grants, and/or consultancy fees for Sanofi and Regeneron, Lilly, Dermira, Novartis, AbbVie, SUN Pharma, Pfizer, Leo, Menlo Therapeutics, GpSkin, Skin Active Scientific, the National Eczema Association, and Global Parents for Eczema Research unrelated to this manuscript.

HDH, AJH, and JPF have no conflict of interests to declare.