4.3 Article

Rosacea associated with dupilumab therapy

Journal

JOURNAL OF DERMATOLOGICAL TREATMENT
Volume 32, Issue 1, Pages 114-116

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/09546634.2019.1624683

Keywords

Dupilumab; atopic dermatitis; rosacea

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A female with atopic dermatitis developed rosacea-like reactions temporally associated with dupilumab injections, which resolved after discontinuation of the drug. Th2 pathway inhibition by dupilumab may promote Demodex proliferation and increased IL-17-mediated inflammation implicated in the pathophysiology of rosacea.
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.

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