Biologic drugs induced vitiligo: case reports and review of literature

Biological drugs are extensively used to treat various inflammatory diseases, including psoriasis, atopic dermatitis (AD), and rheumatoid arthritis. While generally effective and safe, these therapies have been increasingly associated with secondary development of vitiligo, especially with anti-TNF...

Full description

Saved in:
Bibliographic Details
Published in:Frontiers in immunology Vol. 15; p. 1455050
Main Authors: Shao, Xinyi, Chen, Tingqiao, Pan, Xingyu, Chen, Shuang, Chen, Yangmei, Chen, Jin
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media SA 17.12.2024
Frontiers Media S.A
Subjects:
Adolescent
Aged, 80 and over
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
Atopic dermatitis
Biological products
Biological Products - adverse effects
Biological Products - therapeutic use
biological therapy
Case reports
Crohn's disease
cytokine imbalance
Dermatitis
Dermatitis, Atopic - drug therapy
Drug development
Drug dosages
dupilumab-induced vitiligo
Erythema
Female
Females
Fungal infections
Helper cells
Homeostasis
Humans
Immunology
Inflammatory diseases
inflammatory skin diseases
Legs
Literature reviews
Lymphocytes T
Male
Patients
Psoriasis
Rheumatoid arthritis
Steroids
Tumor necrosis factor
Vitiligo
Vitiligo - chemically induced
atopic dermatitis
inflammatory skin diseases
dupilumab-induced vitiligo
biological therapy
cytokine imbalance
ISSN:1664-3224, 1664-3224
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Biological drugs are extensively used to treat various inflammatory diseases, including psoriasis, atopic dermatitis (AD), and rheumatoid arthritis. While generally effective and safe, these therapies have been increasingly associated with secondary development of vitiligo, especially with anti-TNF α and anti-IL17 drugs. Dupilumab, an IL-4 receptor alpha antagonist used in moderate to severe AD, rarely induces vitiligo. This study reports two cases of new-onset vitiligo following dupilumab treatment for AD. The first case involves an 80-year-old male who developed vitiligo patches appeared on the chest, back, and lower limbs after 2 months of dupilumab therapy. Despite discontinuation of dupilumab, the vitiligo did not regress. The second case describes a 14-year-old female who experienced depigmentation on her forehead one month into dupilumab treatment, with partial improvement of vitiligo lesions over time despite continued therapy. This phenomenon may be due to dupilumab blocking type 2 inflammation, disrupting normal skin homeostasis, and exacerbating type 1 inflammation. These cases, supplemented with a literature review, highlight the potential for biologic drug-induced vitiligo and underscore the need for awareness of such adverse events in clinical practice. The mechanisms underlying this phenomenon likely involve disruption of the Th1/Th2/Th17 cytokine balance, suggesting that targeted therapies may inadvertently exacerbate type 1 inflammation, leading to vitiligo. With the rising use of biologics, clinicians should carefully consider the risk of vitiligo when prescribing these treatments.
Bibliography:SourceType-Scholarly Journals-1
content type line 14
ObjectType-Report-1
ObjectType-Case Study-2
ObjectType-Review-5
ObjectType-Feature-4
content type line 23
ObjectType-Article-3
Edited by: Chris Wincup, King’s College Hospital NHS Foundation Trust, United Kingdom
Carlo Alberto Maronese, IRCCS Ca ‘Granda Foundation Maggiore Policlinico Hospital, Italy
Adeeb Bulkhi, Umm Al Qura University, Saudi Arabia
Reviewed by: Devis Benfaremo, Marche Polytechnic University, Italy
Elizabeth Spencer, Icahn School of Medicine at Mount Sinai, United States
These authors have contributed equally to this work
ISSN:1664-3224
1664-3224
DOI:10.3389/fimmu.2024.1455050