中华临床免疫和变态反应杂志2025，Vol.19Issue(6)：414-422,9.DOI:10.3969∕j.issn.1673-8705.2025.06.003
度普利尤单抗治疗特应性皮炎并发全身湿疹样矛盾性反应:4例报告及机制探讨
Four cases of eczematous paradoxical reactions during dupilumab treatment for atopic dermatitis:A case series and literature review
梁桂熔 1王鑫 1程海艳 1张蕊娜 1李妍 1李邻峰1
作者信息
- 1. 100050 北京,首都医科大学附属北京友谊医院皮肤科
- 折叠
摘要
Abstract
Objective To report four clinical cases of paradoxical reactions(PR)during dupilumab treatment for atopic dermatitis(AD),and to conduct a literature review.Methods This retrospective case series analyzed four patients with moderate-to-severe AD who received dupilumab treatment at Beijing Friend-ship Hospital,Capital Medical University between October 2023 and August 2024.All patients received an ini-tial 600 mg subcutaneous loading dose of dupilumab,followed by 300 mg every two weeks for at least 8 weeks.Clinical assessments at baseline and weeks 8 included:Body surface area index(BSA),Investigator's global assessment(IGA),Eczema area and severity index(EASI),SCORing atopic dermati-tis(SCORAD),Numeric rating scale(NRS)for pruritus,and NRS for sleep disturbance.Adverse drug reactions were also monitored.Results All four patients experienced significant pruritus relief post-first injec-tion.Between days 3-14,new symmetrical pruritic erythematous eruptions developed on the trunk and limbs,resolving spontaneously within days.Similar rashes occurred after each subsequent injection but gradually dimin-ished in severity.After 8 weeks of treatment,three patients achieved complete resolution of both new erythema and baseline lesions.One patient discontinued due to worsening rash and pruritus.During 6-13 months of follow-up,no severe adverse drug reactions were observed in any patient.Conclusion Dupilumab demonstrates ro-bust efficacy and a favorable safety in the treatment of AD.For confirmed AD cases,PR occurrence may not ne-cessitate treatment discontinuation as most reactions resolve spontaneously with continued therapy,yielding sat-isfactory long-term outcomes.However,for patients experiencing persistent and severe PRs with diminished therapeutic motivation,treatment cessation and alternative therapies should be considered.关键词
特应性皮炎/生物制剂/矛盾性反应/度普利尤单抗Key words
atopic dermatitis/biologics/paradoxical reaction/dupilumab引用本文复制引用
梁桂熔,王鑫,程海艳,张蕊娜,李妍,李邻峰..度普利尤单抗治疗特应性皮炎并发全身湿疹样矛盾性反应:4例报告及机制探讨[J].中华临床免疫和变态反应杂志,2025,19(6):414-422,9.
