Psoriasiform eruption induced by dupilumab successfully treated with upadacitinib.

Abstract

Psoriasiform eruptions are increasingly reported as adverse events during treatment of atopic dermatitis (AD) with interleukin (IL)-4/IL-13 inhibitors, including dupilumab. These reactions may represent a possible overlap manifestation between AD and psoriasis (PSO), which are two conditions that, according to recent literature, could lie along a clinical spectrum and share certain clinical, pathogenetic, and histological features. We describe the case of a 30-year-old male with lifelong AD who developed psoriasiform plaques on his elbows and knees during dupilumab therapy. After discontinuation of dupilumab and initiation of upadacitinib 15 mg/day, the patient achieved substantial improvement of both AD and psoriasiform eruptions at 6 months. This case highlights dupilumab-induced psoriasiform eruptions and underscores the therapeutic challenges associated with these clinical pictures. Upadacitinib appears to be a possible and effective treatment option for these presentations.