Retrospective study identifies potential for misdiagnosed mycosis fungoides and for dupilumab to fuel cutaneous lymphoid reactions that mimic mycosis fungoides in patients with atopic dermatitis.
Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit.treatment can cause a benign reversible lymphoid reaction that mimics mycosis fungoides but differs histologically, according to a study published on October 18 in
For the study, researchers retrospectively examined records of 530 patients with AD treated with dupilumab at the University Medical Center Utrecht in the Netherlands. Reviewing pretreatment biopsies revealed that among 14 patients who developed clinical suspicion ofAll 14 patients with LR initially responded to dupilumab then developed worsening symptoms at a median of 4 months.
For dermatopathologists, Guitart recommended a cautious approach that resists overdiagnosing MF and acknowledging that insufficient evidence exists to report such reactions as benign. The fact that one study patient had both MF and LR raises concerns that the LR may not always be reversible, Guitart added.
Sidbury added that the study and accompanying editorial also will alert clinicians to the potential for newer AD biologics that target solely IL-13 and not IL-4/13, as dupilumab does."If the deregulated response leading to LR and potentially MF in the affected few is driven by IL-4 inhibition," he said,"drugs such as tralokinumab , lebrikizumab , and perhaps other newer options might calm AD without causing LRs.
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