Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 1;43(10):714-720.
doi: 10.1097/DAD.0000000000001875.

Evolution of Dupilumab-Associated Cutaneous Atypical Lymphoid Infiltrates

Olayemi Sokumbi  1 , Huma Shamim  2 , Mark Dennis P Davis  2 , David A Wetter  2 , Catherine C Newman  2 , Nneka Comfere  2   3
Affiliations

Evolution of Dupilumab-Associated Cutaneous Atypical Lymphoid Infiltrates

Olayemi Sokumbi et al. Am J Dermatopathol. .

Abstract

Background: Observations highlighting the "unmasking" of cutaneous T-cell lymphoma after treatment with dupilumab for atopic dermatitis (AD) have been recently reported. However, there remains a paucity of literature describing the evolution of clinical and histopathological features that characterizes this phenomenon.

Objective: To define the clinical and histopathologic evolution of atypical lymphoid infiltrates after the administration of dupilumab for AD.

Methods: A cross-sectional study of clinical and histopathologic features in 7 consecutive patients with a diagnosis of "atypical lymphoid infiltrate" or mycosis fungoides (MF) on dupilumab for AD was performed.

Results: Seven patients with atypical lymphoid infiltrates or MF in evolution after dupilumab therapy (age range 27-74 years) were reviewed. Average duration of AD before MF diagnosis was 5.7 years, and the average duration on dupilumab treatment was 9.8 months. Notable histopathologic features across predupilumab and postdupilumab biopsies included progressive increase in the densities of the atypical lymphoid infiltrates (7/7), presence of atypical epidermotropic lymphocytes (6/7), and papillary dermal fibrosis (6/7).

Limitations: Small retrospective cohort study.

Conclusion: These cases highlight the transformation of lymphoid infiltrates after dupilumab treatment for AD and emphasize the importance of clinical and histopathologic evaluation before and during treatment with dupilumab for treatment-refractory presumed AD.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Willemze R, Jaffe ES, Burg G, et al. WHO-EORTC classification for cutaneous lymphomas. Blood. 2005;105:3768–3785.
    1. Zhang Y, Wang Y, Yu R, et al. Molecular markers of early-stage mycosis fungoides. J Invest Dermatol. 2012;132:1698–1706.
    1. Mehrany K, El-Azhary RA, Bouwhuis SA, et al. Cutaneous T-cell lymphoma and atopy: is there an association?. Br J Dermatol. 2003;149:1013–1017.
    1. Gooderham MJ, Hong HC, Eshtiaghi P, et al. Dupilumab: a review of its use in the treatment of atopic dermatitis. J Am Acad Dermatol. 2018;78(3 suppl 1):S28–S36.
    1. Saulite I, Hoetzenecker W, Weidinger S, et al. Sézary syndrome and atopic dermatitis: comparison of immunological aspects and targets. Biomed Res Int. 2016;2016:9717530.