Onset of Schamberg Disease and Resolution of Alopecia Areata During Treatment of Atopic Dermatitis With Dupilumab

摘要

Atopic dermatitis (AD) is a chronic pruritic immunemediated inflammatory dermatosis with a high prevalence both in children and in adults.Its pathogenesis is multifactorial, including genetic, immunological, and environmental factors that cause skin barrier dysfunction, alterations in cell-mediated immune responses, and IgE-mediated hypersensitivity.Dupilumab is an interleukin 4 (IL-4) receptor 伪 antagonist that inhibits IL-4/IL-13 signaling through blockade of the shared receptor subunit for IL-4伪.This in turn leads to downregulation of the TH2 immune response, which is the mechanism responsible for the efficacy of dupilumab in patients with AD [1].Schamberg disease, also known as progressive pigmented purpuric dermatitis, is the most common pigmented purpuric dermatosis.It is a recurrent skin disorder characterized by nonpalpable symmetrical pinpoint petechial and pigmented macules, purpura, and, sometimes, telangiectasia, especially on the extremities [2].The etiology is unknown, although immunemediated mechanisms may play a role.Alopecia areata (AA) is an autoimmune nonscarring alopecia with heterogeneous severity that affects up to 2% of the general population.Currently available treatment options for AA are of limited efficacy and have been associated with adverse effects.