Crusted Scabies and Dupilumab: A Case from Brazil ➜ DOI: 10.25259/IJDVL_753_2024 Crusted scabies is typically seen only in immunocompromised patients. This case from Brazil underscores the need for heightened vigilance in atopic dermatitis (AD) patients undergoing dupilumab treatment, particularly if they experience a sudden worsening of pruritus or lesions. More broadly, it highlights the risk of parasitic infections in endemic regions among patients treated with anti-T2 cytokine therapies. Parasitic infections have already been linked to anti-IgE omalizumab and other anti-T2 cytokine antibodies, including mepolizumab (anti-IL-5) and benralizumab (anti-IL-5 receptor).
Seasonal Severity of AD by Birth Season: What’s the Culprit? ➜ DOI: 10.2340/actadv.v105.41987 This Chinese study investigated seasonal variations in AD exacerbation among patients born in different seasons, carefully tracking severity using standardized scoring. The researchers found that patients born in the summer experienced the most severe symptoms and itching during the summer, whereas those born in other seasons showed no clear seasonal pattern. Winter AD exacerbations are typically linked to low temperatures and a weakened skin barrier, caused by reduced epidermal lipids, decreased skin hydration, and lower levels of natural moisturizing factor components. However, in Jiangsu, China, the authors speculate that patients born in the summer may experience heightened AD symptoms and itching during summer due to high temperatures and sweat-induced irritation.
Primary Atopic Disorders (PADs): When Should This Be Considered? ➜ DOI: 10.1016/j.coi.2025.102538 Traditionally regarded as polygenic, multifactorial disorders, allergic diseases can also arise from single-gene defects that affect the immune system and skin epithelial barrier, leading to profoundly dysregulated allergic responses. These monogenic allergic disorders are collectively known as primary atopic disorders (PADs). To date, more than 48 single-gene defects have been identified as causes of PADs. This insightful review highlights: the clinical significance of PADs; the biological pathways involved in their pathogenesis; clinical strategies to differentiate PADs from their much more common polygenic counterparts; diagnostic approaches for identifying PADs.
Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) Lower the Risk of New-Onset Atopic Dermatitis in Diabetic Patients: Another Clue in the Salt Debate? ➜ DOI: 10.1093/bjd/ljaf086 Animal studies suggest that blocking sodium ion channels can help reduce skin inflammation. SGLT2 inhibitors (SGLT2i) work by inhibiting sodium and glucose reabsorption in the renal proximal tubules, leading to increased excretion. This large-scale Taiwanese study found that SGLT2i use in diabetic patients significantly reduces the risk of developing atopic dermatitis (AD), particularly at higher doses. The protective effect was consistent across different types of SGLT2 inhibitors, with male users experiencing a lower risk. Researchers hypothesize that this benefit may be linked to lower skin sodium concentrations, adding another dimension to the ongoing discussion about salt’s role in AD.
Targeting the OX40-OX40L Pathway: A New Era in AD Management? ➜ DOI: 10.1016/j.jaci.2025.02.007 The STREAM-AD trial, a phase 2b study of amlitelimab published in JACI, offers a timely review by Japanese researchers on OX40-OX40L targeting in AD. The trial highlights amlitelimab’s potential as a safe, effective treatment for moderate-to-severe AD, with a key advantage: sustained response even after treatment withdrawal, unlike existing therapies that require continuous use to prevent relapse. By targeting OX40L, amlitelimab may rebalance T-cell populations and reduce inflammation, as seen in lower TH2 and TH17/TH22 biomarkers. Its potential for extended dosing intervals could ease treatment burdens, benefiting patients struggling with adherence or seeking more convenient options. The authors stress the need for further research on its long-term effects on memory T cells and disease recurrence.
