{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:45:19Z","timestamp":1788432319457,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Trials and real\u2010life studies demonstrated clinically meaningful improvements of disease activity in the majority of patients with moderate to severe atopic dermatitis (AD) treated with the anti\u2010IL\u20104RA\u2010antibody dupilumab. However, misdiagnosis or confounding skin diseases in particular cutaneous T\u2010cell lymphoma (CTCL) may lead to inadequate response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the clinical and pathological features of patients with AD who showed insufficient response to dupilumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed the medical records of 371 patients treated with dupilumab for severe AD. Insufficient response was defined as failure to achieve an improvement of the eczema area severity index (EASI) of at least 50% (EASI\u201050) at Week 16 and of 75% (EASI\u201075) at Week 52. Among 46 patients with insufficient response, 35 patients consented to a re\u2010evaluation including a full physical exam, biopsies and laboratory assessments including immunohistochemistry and T\u2010cell receptor gene rearrangement analysis to differentiate CTCL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 371 patients treated with dupilumab, 46 (12.3%) patients showed insufficient response to dupilumab. Of these, 35 underwent further evaluation, and 19 (54.2% of inadequate responders) were finally diagnosed with mycosis fungoides (MF). In these patients, transition to or addition of conventional MF treatment led to clinical improvements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Insufficient response to dupilumab treatment may help uncover early MF on an existing AD background.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.20053","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T10:30:02Z","timestamp":1714473002000},"page":"1939-1946","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Detecting T\u2010cell receptor clonality in patients with severe atopic dermatitis refractory to dupilumab"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6687-2125","authenticated-orcid":false,"given":"Hyungdon","family":"Kook","sequence":"first","affiliation":[{"name":"National Medical Center  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Eun","family":"Gwag","sequence":"additional","affiliation":[{"name":"National Medical Center  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4747-0248","authenticated-orcid":false,"given":"So Yun","family":"Park","sequence":"additional","affiliation":[{"name":"National Medical Center  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6542-4811","authenticated-orcid":false,"given":"Narang","family":"Hong","sequence":"additional","affiliation":[{"name":"National Medical Center  Seoul 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