What if Dupilumab Breaks the Rules? A Case Report and Review in Psoriasis-Atopic Dermatitis Overlap

A 33-years-old woman entered the dermatological departments with numerous itchy nodular manifestation all over the entire lower surface of the legs. The patient reported intense itching also present around the body particularly in the flexor areas. She also presented psoriasiform lesion in the pre-tibial area, which has always been recognized as a difficult to treat area in psoriasis. Treatment with both topical and systemic steroids caused only temporary improvement. Histological esamination reported psoriasiform dermatitis associated with spongiosis phenomena in dermis, confirming a clinical overlap psoriasis-atopic dermatitis. Traditional systemic therapies and JAK-inihibitors were controindicated. Therapy with Dupilumab demonstrated efficacy in both psoriasiform and atopic clinical manifestations, despite the limited evidence in literature. We present our experience with literature revision.