Korean J Dermatol.  2023 Feb;61(2):140-142.

Excited Skin Syndrome after Patch Testing in a Patient with Atopic Dermatitis Treated with Dupilumab

• Lee MY
• Kim YJ
• Lee WJ
• Chang SE
• Lee MW
• Won CH

Abstract

The effect of dupilumab on allergic contact dermatitis or patch testing is unknown. Here, we present a case of excited skin syndrome that appeared after patch testing during dupilumab treatment. A 21-year-old woman presented with atopic dermatitis that showed only a partial response to cyclosporine and dupilumab. A patch test was performed to check for underlying allergic contact dermatitis. The result was consistent with excited skin syndrome. Some studies argue that dupilumab suppresses allergic reactions triggered by allergens that activate the Th2 pathway. Others suggest that it does not affect the result of patch testing, regardless of the type of allergen tested. Even if dupilumab suppresses a certain allergic or immunologic pathway, this case shows that it cannot mask excited skin syndrome on patch testing.

Keyword

Atopic dermatitis; Dupilumab; Patch tests