Department of Dermatology, National Medical Center, Seoul, South Korea.
Department of Dermatology, Chosun University College of Medicine, Gwangju, South Korea.
J Eur Acad Dermatol Venereol. 2022 Nov;36(11):2140-2152. doi: 10.1111/jdv.18327. Epub 2022 Jul 18.
The development of dermatitis on face and neck, which was not described in phase 3 clinical trials, has been reported in the literature in patients treated with dupilumab. Little is known regarding the causes or defining features of the facial dermatitis.
We conducted surveys of consecutive patients with AD on dupilumab to describe its clinical features, morphology and aetiology.
A multi-centre prospective cohort study was conducted from 1 January 2020, to 31 December 31 2020. A total of 162 patients under dupilumab treatment were asked to complete a questionnaire and patients were evaluated by dermatologists.
Of all 162 patients, 137 (84.6%) patients reported pre-existing facial dermatitis prior to dupilumab therapy. One hundred and twenty-one (88.3%) patients with pre-existing facial dermatitis reported improvement of their facial dermatitis with dupilumab therapy, nine (6.6%) patients reported no change after the treatment and seven (4.3%) patients of them got worse after the treatment (exacerbation group). Of 25 patients who reported no pre-existing active facial dermatitis, six (24%) patients reported new-onset facial erythema after the starting dupilumab therapy (new-onset group). A large proportion of the patients in both the exacerbation (86%) and new-onset groups (67%) had a history of facial TCS use. Both groups showed similar clinical manifestations and distribution with few differences.
The vast majority of patients treated with dupilumab in academic institutions from Korea and the United States experienced improvement in their facial dermatitis with dupilumab therapy. A small proportion of patients had new onset and exacerbation. Although the mechanisms of this adverse event remain unclear, steroid withdrawal should be considered as a diagnosis of the erythema in some patients.
在接受度匹鲁单抗治疗的患者的文献中报告了面部和颈部皮炎，这在 3 期临床试验中未描述。对于面部皮炎的病因或特征了解甚少。
我们对接受度匹鲁单抗治疗的特应性皮炎（AD）连续患者进行了调查，以描述其临床特征、形态和病因。
一项多中心前瞻性队列研究于 2020 年 1 月 1 日至 2020 年 12 月 31 日进行。共有 162 名接受度匹鲁单抗治疗的患者被要求完成一份问卷，并且由皮肤科医生对患者进行评估。
在所有 162 名患者中，137 名（84.6%）患者在接受度匹鲁单抗治疗前报告有面部皮炎。121 名（88.3%）有面部皮炎的患者报告他们的面部皮炎在接受度匹鲁单抗治疗后得到改善，9 名（6.6%）患者报告治疗后无变化，7 名（4.3%）患者恶化（加重组）。在报告无活动性面部皮炎的 25 名患者中，有 6 名（24%）患者在开始接受度匹鲁单抗治疗后出现新的面部红斑（新发组）。在加重组（86%）和新发组（67%）中，很大一部分患者有面部 TCS 使用史。两组的临床表现和分布相似，仅有一些差异。
在韩国和美国的学术机构接受度匹鲁单抗治疗的绝大多数患者的面部皮炎在接受度匹鲁单抗治疗后得到改善。少数患者出现新发和加重。尽管这种不良反应的机制尚不清楚，但在一些患者中，应考虑停用类固醇以诊断红斑。
