Something to Sweat About: Two Cases of Dupilumab-Induced Hyperhidrosis and Bromhidrosis
| Autor: | Robert Hostoffer, Devi Jhaveri, Marija Rowane, Reimus Valencia, Jason Schend |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
lcsh:Immunologic diseases. Allergy medicine.medical_specialty Alpha (ethology) Case Report SWEAT 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Receptor subunit Immunology and Allergy Medicine hyperhidrosis atopic dermatitis business.industry Hyperhidrosis Inflammatory skin disease Atopic dermatitis medicine.disease lcsh:Otorhinolaryngology Dupilumab Dermatology lcsh:RF1-547 dupilumab (Dupixent®) 030104 developmental biology Otorhinolaryngology Etiology eczema bromhidrosis medicine.symptom business lcsh:RC581-607 |
| Zdroj: | Allergy & Rhinology, Vol 11 (2020) Allergy & Rhinology |
| ISSN: | 2152-6567 |
| Popis: | Introduction Atopic dermatitis (AD, eczema) is familial chronic inflammatory skin disease of complex etiology and increasing prevalence. Dupilumab is an IL-4 receptor subunit alpha (IL-4Rα) antagonist that is the first Food and Drug Administration-approved biological therapy for moderate-to-severe adult AD inadequately controlled with topical therapies. Adverse effects reported in the literature include injection site reactions, conjunctivitis, headache, and nasopharyngitis. Objective We report the first cases of hyperhidrosis and bromhidrosis as side effects from dupilumab (Dupixent®) for the treatment of AD. Case Reports Case 1 is a 20-year-old woman with controlled allergic rhinitis and severe AD reported axillary hyperhidrosis with bromhidrosis, comparable to sweat from high-intensity exercise, with no relief from several different over-the-counter antiperspirants. Case 2 is a 61-year-old woman with history of chronic asthma, allergic contact dermatitis, allergic rhinitis, and AD noticed markedly increased sweating with bromhidrosis that was reminiscent of her menopausal symptomology, about 3 months after initiating dupilimab. Discussion Traditional immunosuppressive agents and corticosteroids have limited efficacy, numerous side effects, and increased risk of infection. The safety profile and efficacy of the newly approved IL-4Rα antagonist dupilumab may be favorable to oral immunosuppressants, but its use remains limited to severe recalcitrant cases, due to financial implications and lack of long-term safety data and comparative head-to-head trials. Conclusion We report improved outcomes with dupilumab, in addition to unpublished cases of bromhidrosis and hyperhidrosis in 2 patients with AD. This report of additional complications may inspire further clinical research and assist clinicians in considering the option of dupilumab for uncontrolled AD, despite aggressive traditional treatment. |
| Databáze: | OpenAIRE |
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