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. 2023 Mar 31;13(4):634.
doi: 10.3390/biom13040634.

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

Henning Olbrich  1 , Christian D Sadik  1 , Ralf J Ludwig  1   2 , Diamant Thaçi  1   3 , Katharina Boch  1
Affiliations

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

Henning Olbrich et al. Biomolecules. .

Abstract

Dupilumab was first approved for the treatment of atopic dermatitis (AD) and blocks the signaling of interleukin (IL)-4 and -13. Several other chronic skin conditions share mechanistic overlaps with AD in their pathophysiology, i.e., are linked to type 2 inflammation. Most recently, dupilumab was approved by the U.S. Food and Drug Administration for prurigo nodularis (PN). Given its relatively good safety profile, effective off-label use of dupilumab has been reported for a multitude of dermatologic diseases and several clinical trials for dermatologic skin conditions are currently ongoing. We conducted a systematic review of applications of dupilumab in dermatology other than AD and PN by searching the databases PubMed/Medline, Scopus, Web of Science and Cochrane Library as well as the clinical trial registry ClinicalTrials.gov. We found several reports for effective treatment of bullous autoimmune diseases, eczema, prurigo, alopecia areata, chronic spontaneous urticaria, Netherton syndrome and a variety of other chronic inflammatory skin diseases.

Keywords: alopecia areata; atopic dermatitis; bullous pemphigoid; chronic spontaneous urticaria; contact dermatitis; dupilumab; eczema; prurigo nodularis; pruritus; review.

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Conflict of interest statement

All authors have read the journal’s policy and the authors of this manuscript have the following competing interests: D.T. received honoraria and lecture fees from AbbVie, Almirall, Amgen, Biogen Idec, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Leo Pharma, Novartis, Pfizer, Regeneron, Roche-Posay, Sanofi, Target-Solution and UCB. All other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Clinical presentations of chronic inflammatory skin diseases with reports of effective dupilumab treatment. (A) Severe nummular eczema with confluent itchy and scaly plaques showing superficial excoriations. (B) Chronic prurigo presenting with intensely pruritic nodules that are developed and sustained by pathognomonic itch-scratch cycles. Deep scratching results in visible scars. (C) Tense clear or hemorrhagic blisters on reddish and infiltrated skin typically seen in bullous pemphigoid. (D) Nonscarring patchy hair loss on the scalp in a patient with alopecia areata. Progression can lead to total hair loss of the head (alopecia totalis, AT) or even the entire body (alopecia universalis, AU). (E) Chronic urticaria presenting with recurrent wheals that form and fade in rapid succession and can be accompanied with itch. (F) A pediatric patient with Netherton syndrome presenting with severe itchy chronic infiltration, lichenification and papulation of the skin resembling atopic dermatitis. (G) Mycosis fungoides in an elderly patient with localized dark patches on the trunk that are highly pruritic.
Figure 2
Figure 2
PRISMA flow diagram depicting the different phases of this systematic review.
See this image and copyright information in PMC

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