RESUMEN
Bullous pemphigoid is often difficult to treat with the limited therapies available. Here, we describe clinical outcomes among 30 adults with bullous pemphigoid patients treated with dupilumab. We performed a multicenter, retrospective case series between March 2020 to August 2022. Patients received a loading dose of dupilumab 600 mg, followed by 300 mg maintenance dose with varying administration frequency tailored to individual patient response. All patients experienced at least some improvement in blister formation and pruritus, with 23 (76.7%) of patients demonstrating either complete clearance of blistering or marked response. Complete clearance of pruritus or marked response was noted in 25 (83.3%) of patients. Eight patients were effectively maintained solely on dupilumab. One (3.3%) patient reported an injection site reaction. Thirty patients represent a small sample, however, to our knowledge, this is the second largest group of BP treated with dupilumab. Furthermore, we provide an understandable framework for clinicians outside of academics to follow and assess treatment responses in their BP patients treated with dupilumab. Dupilumab should be considered as a therapeutic option in patients with bullous pemphigoid given its ability to induce sustained blistering and pruritus response in both typical and refractory cases while maintaining a favorable safety profile. J Drugs Dermatol. 2024;23(6):e144-e148. doi:10.36849/JDD.8258e.
Asunto(s)
Anticuerpos Monoclonales Humanizados , Penfigoide Ampolloso , Prurito , Humanos , Penfigoide Ampolloso/tratamiento farmacológico , Penfigoide Ampolloso/diagnóstico , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/efectos adversos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Estudios Retrospectivos , Femenino , Masculino , Anciano , Persona de Mediana Edad , Resultado del Tratamiento , Anciano de 80 o más Años , Prurito/tratamiento farmacológico , Prurito/etiología , Prurito/diagnóstico , Adulto , Reacción en el Punto de Inyección/etiología , Reacción en el Punto de Inyección/diagnósticoAsunto(s)
Migrantes , Humanos , Estados Unidos , Dermatólogos , Accesibilidad a los Servicios de SaludAsunto(s)
Cuidados Posteriores , Dermatología , Estudios de Seguimiento , Humanos , Alta del Paciente , PacientesAsunto(s)
Pueblo Asiatico/estadística & datos numéricos , Dermatología/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Enfermedades de la Piel/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Instituciones de Atención Ambulatoria/estadística & datos numéricos , California/epidemiología , Niño , China/etnología , Eccema/epidemiología , Eccema/terapia , Femenino , Humanos , Renta/estadística & datos numéricos , Lenguaje , Masculino , Área sin Atención Médica , Persona de Mediana Edad , Estudios Retrospectivos , Factores Sexuales , Enfermedades de la Piel/etnología , Enfermedades de la Piel/terapia , Viaje/estadística & datos numéricos , Adulto JovenRESUMEN
ABSTRACT: Systemic corticosteroids are commonly used as a short-term management option for inflammatory skin conditions, such as contact dermatitis. The purpose of our systematic review was to compare presence and degree of patch test reactions with or without different doses of systemic corticosteroid therapy. The relationship between 20, 30, and 40 mg daily doses of prednisone and retained, diminished, and negated reactions was not linear, whereas the reaction ratings for all patches placed with or without corticosteroid therapy revealed trends toward lower intensity reactions while receiving prednisone ( P < 0.0001, χ 2 , for all doses of prednisone). Our review provides insight into directions for future studies that examine the effect of corticosteroids on patch testing.
Asunto(s)
Corticoesteroides , Dermatitis por Contacto , Humanos , Pruebas del Parche , Prednisona/uso terapéutico , Corticoesteroides/efectos adversos , Glucocorticoides/efectos adversosRESUMEN
A 56-year-old woman was admitted for myeloablative conditioning in preparation for allogeneic hematopoietic cell transplant. Her course was complicated by severe mucositis, acute kidney injury, and neutropenic fever. During her admission, she also developed painful necrotic skin lesions, a nonproductive cough, and altered mental status. What is your diagnosis?