Pediatric dermatology · 2025
Post-Hematopoietic Stem Cell Transplantation Eczematous Dermatitis Spectrum Successfully Treated With Dupilumab: A Case Series and Review of the Literature.
СтатьяОбзорМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Rodríguez-Sánchez Belén, Campos-Domínguez Minia, Del Alcalá-Ramírez Del Puerto Antonio, Bernabeu-Wittel José, Monserrat-García María Teresa, Arias-Lotto Francisco, Parra-Blanco Veronica, Beléndez-Bieler Cristina, García-Morín Marina, Bardón-Cancho Eduardo, Marco-Sánchez Jose Manuel, González-Gerrero Alba, Baselga-Torres Eulàlia, Prat-Torres Carolina
Аннотация
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is associated with several dermatological adverse events, including the de novo onset of pruritus and eczema. Some authors consider this a variant of graft-versus-host disease (GvHD) and refer to it as eczematous or atopic dermatitis (AD)-like GvHD, while others categorize it separately as eczematous or AD-like dermatitis. This study aimed to report a pediatric case series and review previously published cases treated with dupilumab.
METHODS: Retrospective multicenter study including patients aged 0-18 treated with dupilumab for new eczematous lesions following HSCT up to 2024 in three tertiary hospitals in Spain. A literature review in PubMed identified all reported pediatric and adult cases.
RESULTS: A total of 24 cases were identified: 9 from our centers and 15 from the literature. Median onset was 3 months post-HSCT. All patients presented with pruritus and eczema. 47% showed flexural involvement. Histology revealed eczematous features in 73%, mixed GvHD/eczema in 20%, and pure GvHD in 7%. 38% were classified as post-HSCT eczema, and 63% as eczematous or AD-like GvHD. All were refractory to topical corticoids and different systemic immunosuppressants. Dupilumab led to complete or near-complete resolution in 96% of cases. No serious adverse events were reported.
CONCLUSION: Dupilumab appears to be effective and safe for eczematous lesions occurring after HSCT, regardless of whether the histopathological characteristics align with eczema or GvHD. This supports a shared spectrum between eczematous dermatitis and GvHD, and the use of a neutral diagnostic term. Further research is needed to clarify its pathogenesis.
METHODS: Retrospective multicenter study including patients aged 0-18 treated with dupilumab for new eczematous lesions following HSCT up to 2024 in three tertiary hospitals in Spain. A literature review in PubMed identified all reported pediatric and adult cases.
RESULTS: A total of 24 cases were identified: 9 from our centers and 15 from the literature. Median onset was 3 months post-HSCT. All patients presented with pruritus and eczema. 47% showed flexural involvement. Histology revealed eczematous features in 73%, mixed GvHD/eczema in 20%, and pure GvHD in 7%. 38% were classified as post-HSCT eczema, and 63% as eczematous or AD-like GvHD. All were refractory to topical corticoids and different systemic immunosuppressants. Dupilumab led to complete or near-complete resolution in 96% of cases. No serious adverse events were reported.
CONCLUSION: Dupilumab appears to be effective and safe for eczematous lesions occurring after HSCT, regardless of whether the histopathological characteristics align with eczema or GvHD. This supports a shared spectrum between eczematous dermatitis and GvHD, and the use of a neutral diagnostic term. Further research is needed to clarify its pathogenesis.