{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:29:37Z","timestamp":1791872977214,"version":"4.3.4"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:sec id=\"ab-doi230050-4\"><jats:title>Importance<\/jats:title><jats:p>Since the increased use of dupilumab for atopic dermatitis (AD) in daily practice, several cases have been reported on the development of cutaneous T-cell lymphomas (CTCL) and lymphoid infiltrates.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230050-5\"><jats:title>Objective<\/jats:title><jats:p>To provide insight in the clinical and histopathologic features of patients with AD clinically suspected for CTCL during dupilumab treatment.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230050-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective observational case series included adult (\u226518 years) patients with AD treated with dupilumab between October 2017 and July 2022 at the University Medical Center Utrecht in the Netherlands.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230050-7\"><jats:title>Main outcomes and measures<\/jats:title><jats:p>Relevant patient, disease, and treatment characteristics were evaluated. Skin biopsies before, during, and after treatment were collected and reassessed.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230050-8\"><jats:title>Results<\/jats:title><jats:p>Fourteen patients (54.5% male) with a median (IQR) age of 56 (36-66) years suspected for CTCL with deterioration of symptoms during dupilumab treatment were included. Of 14 patients, 3 were retrospectively diagnosed with preexistent mycosis fungoides (MF). Eleven patients with AD were eventually diagnosed with a lymphoid reaction (LR). These patients showed MF-like symptoms; however, histopathologic findings were different, and included sprinkled distribution of small hyperchromatic lymphocytes in the upper epidermal section, a dysregulated CD4:CD8 ratio, and CD30 overexpression, without loss of CD2\/CD3\/CD5. The median time to clinical worsening was 4.0 months (IQR, 1.4-10.0). Posttreatment biopsies showed complete clearance of the LR in all patients.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230050-9\"><jats:title>Conclusions and relevance<\/jats:title><jats:p>This study found that dupilumab treatment can cause a reversible and benign LR, which mimics a CTCL, though has distinctive histopathologic features.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2023.3849","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T15:02:43Z","timestamp":1697641363000},"page":"1240","source":"Crossref","is-referenced-by-count":64,"title":["Dupilumab-Associated Lymphoid Reactions in Patients With Atopic Dermatitis"],"prefix":"10.1001","volume":"159","author":[{"given":"Celeste M.","family":"Boesjes","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian F.","family":"van der Gang","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne S.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tess A.","family":"ten Cate","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotte S.","family":"Spekhorst","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies","family":"de Graaf","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijke R.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein S.","family":"de Bruin-Weller","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, 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