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Approach to Erythroderma
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Papuloerythroderma of Ofuji is a disease of unknown etiology, a prelymphomatous condition characterized by the onset of disseminated brownish erythematous papules that converge to produce erythroderma that typically spares the major skin folds. It affects elderly men more often than women. Apart from cutaneous involvement, the most characteristic laboratory finding is peripheral eosinophilia with high levels of immunoglobulin E and lymphopenia. Liver function tests may be abnormal, with elevated alkaline phosphatase and γ-glutamyl transferase. It has also been reported to progress to T-cell lymphoma and is found in association with visceral neoplasms, Hodgkin lymphoma, acute myeloid leukemia, hypereosinophilic syndrome, AIDS, drug hypersensitivity, and biliary sepsis after cholecystectomy. Topical and systemic corticosteroids at low doses along with antihistamines, Psoralen plus ultraviolet A (PUVA), UV-B, retinoid-PUVA, and other treatments, such as cyclosporine, etretinate, azathioprine, and interferon-α, have been used successfully to treat this condition.
Dupilumab use in dermatologic conditions beyond atopic dermatitis – a systematic review
Published in Journal of Dermatological Treatment, 2021
Aleksi J. Hendricks, Gil Yosipovitch, Vivian Y. Shi
First described in 1984, papuloerythroderma of Ofuji (PEO) is characterized by pruritic, widespread coalescing papules that spare the skin folds (“deck-chair sign”) (57,58). PEO most commonly occurs in older males and has been found to be associated with medication exposure, infection or internal malignancy (57,59). Laboratory findings in PEO include peripheral eosinophilia and elevated IgE, indicative of a TH2-driven process (58,59). Recent studies have identified markedly increased IL-4 and IL-13 production by T cells in patients with PEO (60), supporting a potential therapeutic role for dupilumab.
The emerging role of dupilumab in dermatological indications
Published in Expert Opinion on Biological Therapy, 2021
Maddalena Napolitano, Adriana Di Guida, Mariateresa Nocerino, Gabriella Fabbrocini, Cataldo Patruno
High efficacy and tolerability profile of dupilumab has allowed its use in a broad spectrum of skin diseases. In fact, there are isolated reports of the effective use of dupilumab in the treatment of dyshidrotic eczema (DE), Netherton disease (ND), photodermatoses (PD), papuloerythroderma of Ofuji (PEO), eosinophilic annular erythema (EAE), epidermolysis bullosa pruriginosa (EBP). dyshidrotic eczema (DE) is a difficult condition to treat, as it is often associated with an inadequate response to topical and systemic treatment. To date, 19 DE patients have been successfully treated with dupilumab [117–120].