Yuetong Liu,1,* Lanxin Liu,1,* Hongmei Zhou,2 Guangfang Chen,2 Changhui Wen,2 Ran Wu2 

1Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, 550002, People’s Republic of China; 2Department of Dermatology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, 550001, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ran Wu, Department of Dermatology, The first affiliated hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, 550001, People’s Republic of China, Email wuranshou@126.com

Abstract: Atopic dermatitis (AD) and psoriasis (Pso) are both recurrent inflammatory diseases. Recently, it has been reported that a small number of AD patients experience immune drift after receiving dupilumab treatment, leading to a transition from eczema-like lesions to psoriasis-like lesions. Here, we report a case of pustular psoriasis caused by dupilumab treatment for atopic dermatitis. This case underscores the diagnostic challenges associated with immune drift related to biological agents while also highlighting the shortened time frame for immune drift onset compared to previous reports.

Keywords: immune drift, dupilumab, atopic dermatitis, pustular psoriasis