{"title":"Rosacea-like skin reaction under treatment with dupilumab for atopic dermatitis.","authors":"C Grote, F Zirkenbach, J N Wagner, M Augustin","doi":"10.1080/09546634.2025.2452987","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Dupilumab is a widely recommended treatment for moderate-to-severe atopic dermatitis (AD), with known ocular side effects but less frequent cutaneous reactions.</p><p><strong>Material and methods: </strong>This case report details a 52-year-old female patient with atopic dermatitis treated with dupilumab. After an initially successful treatment, the patient developed a rosacea-like dermatitis. At first, dupilumab was continued alongside doxycycline, metronidazole gel and ivermectin cream.</p><p><strong>Results: </strong>Following a worsening of her skin condition, dupilumab was discontinued. Lebrikizumab was introduced, leading to significant regression of the lesions.</p><p><strong>Conclusions: </strong>This case highlights a rare paradoxical skin reaction to dupilumab, potentially linked to the blockade of IL-4Rα, which may shift the immune response towards a Th1/Th17 phenotype. The findings suggest that alternative therapies, such as IL-13 inhibitors, should be considered when cutaneous side effects arise during dupilumab treatment.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"36 1","pages":"2452987"},"PeriodicalIF":0.0000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of dermatological treatment","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/09546634.2025.2452987","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/27 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Dupilumab is a widely recommended treatment for moderate-to-severe atopic dermatitis (AD), with known ocular side effects but less frequent cutaneous reactions.
Material and methods: This case report details a 52-year-old female patient with atopic dermatitis treated with dupilumab. After an initially successful treatment, the patient developed a rosacea-like dermatitis. At first, dupilumab was continued alongside doxycycline, metronidazole gel and ivermectin cream.
Results: Following a worsening of her skin condition, dupilumab was discontinued. Lebrikizumab was introduced, leading to significant regression of the lesions.
Conclusions: This case highlights a rare paradoxical skin reaction to dupilumab, potentially linked to the blockade of IL-4Rα, which may shift the immune response towards a Th1/Th17 phenotype. The findings suggest that alternative therapies, such as IL-13 inhibitors, should be considered when cutaneous side effects arise during dupilumab treatment.