Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.
- Presentation
What's New in Dermatopathology: Updates in Cutaneous Drug Reactions
Description
This presentation in dermatopathology focuses on recent updates regarding cutaneous drug reactions, particularly those associated with dupilumab, mogamulizumab, and immune checkpoint inhibitors. The speaker reviews findings related to dupilumab, a drug used for atopic dermatitis and CTCL, highlighting concerns about lymphoid reactions potentially resembling mycosis fungoides (MF). Studies indicate that some patients initially diagnosed with atopic dermatitis developed MF after treatment, while others had reversible lymphoid reactions. Similar patterns are discussed for mogamulizumab-related skin reactions, which can mimic characteristics of MF and include various histopathological presentations. The differences in immunohistochemical markers are emphasized to distinguish between conditions. The talk also reviews immune checkpoint inhibitor reactions, noting varied presentations such as lichenoid dermatitis and issues in differentiating between benign and malignant lesions like keratoacanthomas. The speaker concludes with suggestions for clinicians, including the importance of thorough biopsies and awareness of potential seasonal patterns in immunotherapy-related side effects.
View moreConclusions
- Dupilumab may lead to atypical lymphoid reactions in patients initially diagnosed with atopic dermatitis, necessitating careful monitoring and potential biopsies to differentiate these from cutaneous T-cell lymphoma (CTCL).
- Patients treated with dupilumab for atopic dermatitis can develop conditions resembling mycosis fungoides (MF) that are reversible upon discontinuation of the drug.
- The differential diagnosis between true MF and dupilumab-associated lymphoid reactions is crucial, highlighting the importance of pre-treatment biopsies.
- Patients experiencing cutaneous eruptions during dupilumab therapy may also show distinct skin reactions compared to previous atopic dermatitis flares.
- Mogamilizumab-associated reactions can exhibit overlapping features with CTCL, indicating the need for comprehensive evaluation of skin changes during treatment.
- Histological comparisons can help identify specific markers that differentiate between mogamilizumab-associated rash and MF.
- Immune checkpoint inhibitors are associated with varied cutaneous adverse reactions, including delayed responses that may occur after treatment has ceased, thus stressing the need for ongoing surveillance even post-therapy.
- Recognition of seasonal patterns in cutaneous reactions related to immunotherapy may aid in understanding and managing these adverse effects.
- Lázaro-Sastre et al., Curr Treat Options Allergy 2019
- Espinosa et al., JAAD 2020
- Sokumbi et al., Am J Dermpath 2021
- Boesjes et al., JAMA Derm 2023
- Wang et al., Am J Surg Path, 2020
- Trum et al., Br J Dermatol, 2022
- Chen et al., JAMA Derm 2019
- Coscarart et al., JCP 2019
- Feldstein et al., JEADV 2017
- Rogiers et al., Eur J Cancer 2024