Two Cases of Immune Drift Phenomena Caused by Biologic Agents for Treating Psoriasis and Atopic Dermatitis

Figures & data

Figure 1 Erythema, papules, scales and excoriation on the waist.

Figure 2 Psoriasis- like lesions: demarcated scaly erythematous lesions.

Figure 3 Histopathology showed psoriasiform acanthosis with a diminished granular layer, lymphocyte infiltration in the superficial dermis. (HE stain, magnification 4*10).

Figure 4 Topical calcipotriol and betamethasone ointment was applied to the psoriasis-like lesions.

Figure 5 (A–D) Erythema, papules, scales on the shoulder (A), back (B), lower limbs (C) and popliteal fossa (D).

Table 1 The Relevant Reports from the Past 5 Years

Title	Author	Year	Disease	Age	Sex	Biologicals	Duration	Management
Our study	Our group	2023	AD AS	1.87 2.30	Female Male	SEC Dupi	8 weeks 1 year	1. Topic calcipotriol/betamethasone 2.Oral antihistamine and topical corticosteroids
Paradoxical eczema in patients with psoriasis receiving biologics: a case series^Citation5	Ali Al-Janabi, et al	2022	PSO	Media age; 49	Male:10 Female:13	ADA;12 ETA: 1 INF:1 IXE:5 SEC:4 GUS:3 UST:10	Media time:109d	No treatment, topical corticosteroids, broad-acting systemic agents, and discontinuation or switch of biologic therapy
Eczematous eruption during anti‐interleukin 17 treatment of psoriasis: an emerging condition^Citation6	M.Napolitano, et al	2019	Pso	Media age:42.5	Male:2 Female:2	SEC:3 IXE:1	Media time; 13.5 weeks	3 cases discontinuation, 1case topical steroids
Dupilumab-induced phenotype switching from atopic dermatitis to psoriasis.^Citation7	Varma A	2020	AD	73	Male	Dupi	4 weeks	Not report
Psoriasis-like Dermatitis Developing in a Patient with Atopic Dermatitis Treated with Dupilumab. Dermatitis^Citation8	Stout M, et al	2019	AD	59	Female	Dupi	25weeks	Discontinution, topical steroids
Occurrence of psoriasiform eruption during dupilumab therapy for adult atopic dermatitis: A case series^Citation9	Napolitano M, et al	2019	AD	Media age:52	Male:2 Female:1	Dupi	15.2 weeks	Topical steroids, Oral prednisone, NB-UVB
Two cases of psoriasiform dermatitis arising during dupilumab therapy and successfully treated with delgocitinib ointment^Citation10	Kazuo KURIHARA, et al	2021	AD	Case 1: 34 Case 2: 23	Male	Dupi	Case 1: 2.5 year Case: 1.5 year	Delgocitinib ointment

Abbreviations: AD, Atopic dermatitis; AS, ankylosing spondylitis; Dupi, dupilumab; SEC, Secuchiumab; ADA, Adalimumab; ETA, Etanercept; INF, Infliximab; IXE, Ixekizumab GUS, Guselkumab UST, Ustekinumab.

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