Detecting T-cell receptor clonality in patients with severe atopic dermatitis refractory to dupilumab
- Authors
- Kook, Hyungdon; Gwag, Ho Eun; Park, So Yun; Hong, Narang; Lee, Jung-Ho; Jung, Hye Jung; Park, Mi Youn; Choi, Yu Sung; Kim, Hyun Je; Weidinger, Stephan; Ahn, Jiyoung
- Issue Date
- Apr-2024
- Publisher
- WILEY
- Citation
- JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
- Journal Title
- JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/26268
- DOI
- 10.1111/jdv.20053
- ISSN
- 0926-9959
1468-3083
- Abstract
- BackgroundTrials and real-life studies demonstrated clinically meaningful improvements of disease activity in the majority of patients with moderate to severe atopic dermatitis (AD) treated with the anti-IL-4RA-antibody dupilumab. However, misdiagnosis or confounding skin diseases in particular cutaneous T-cell lymphoma (CTCL) may lead to inadequate response.ObjectiveTo investigate the clinical and pathological features of patients with AD who showed insufficient response to dupilumab.MethodsWe reviewed the medical records of 371 patients treated with dupilumab for severe AD. Insufficient response was defined as failure to achieve an improvement of the eczema area severity index (EASI) of at least 50% (EASI-50) at Week 16 and of 75% (EASI-75) at Week 52. Among 46 patients with insufficient response, 35 patients consented to a re-evaluation including a full physical exam, biopsies and laboratory assessments including immunohistochemistry and T-cell receptor gene rearrangement analysis to differentiate CTCL.ResultsOf the 371 patients treated with dupilumab, 46 (12.3%) patients showed insufficient response to dupilumab. Of these, 35 underwent further evaluation, and 19 (54.2% of inadequate responders) were finally diagnosed with mycosis fungoides (MF). In these patients, transition to or addition of conventional MF treatment led to clinical improvements.ConclusionInsufficient response to dupilumab treatment may help uncover early MF on an existing AD background.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > Department of Dermatology > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/26268)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.