Cutaneous T-cell lymphomas and dupilumab for atopic dermatitis: A systematic review and expert consensus - PubMed
a day ago
- #Dupilumab
- #Cutaneous T-cell lymphomas
- #Atopic dermatitis
- Dupilumab, a standard treatment for atopic dermatitis (AD), has been associated with cutaneous T-cell lymphomas (CTCL), particularly mycosis fungoides (MF) and Sézary syndrome (SS).
- A systematic review and expert consensus was conducted involving 51 studies and 547 patients to characterize dupilumab-related CTCL emergence.
- New or worsening skin lesions were reported after dupilumab initiation, occurring at a mean of 8.9 months, with MF diagnosed in 72% of cases and SS in 11%.
- Dupilumab was discontinued in 75% of cases, and 62% received CTCL-directed treatment, with clinical remission achieved in 44 of 63 patients with follow-up.
- Expert consensus recommends avoiding dupilumab in cases of MF/SS and mogamulizumab-induced rashes, emphasizing diagnostic vigilance with skin biopsy, histology, and clonality testing.
- Dupilumab should be discontinued once CTCL is confirmed, with methotrexate or phototherapy considered as alternatives, while cyclosporine and JAK inhibitors are deemed unsuitable.
- The consensus provides practical guidance for the safe management of patients, highlighting that dupilumab may unmask or exacerbate CTCL, particularly MF and SS.