{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:22:21Z","timestamp":1788985341497,"version":"build-2803163510"},"reference-count":9,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatol Reports"],"abstract":"<jats:p>Dear Editor,\nParadoxical eczema (PE) is defined as de novo onset or flare of eczematous lesions during biologic therapy for psoriasis, regardless of atopic diathesis. PE has been reported with anti-tumor necrosis factor (TNF)-\u03b1, anti-interleukin (IL)-17, and more recently with anti-IL-23 agents such as risankizumab, tildrakizumab, and guselkumab, with an estimated incidence of 1-3% among psoriatic patients treated with biologics, likely underestimated. Herein, we report the successful use of upadacitinib, an oral selective Janus kinase (JAK)-1 inhibitor approved for both psoriatic arthritis and atopic dermatitis, in the management of a PE induced by guselkumab. [...]<\/jats:p>","DOI":"10.4081\/dr.2026.10644","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T14:50:55Z","timestamp":1770130255000},"source":"Crossref","is-referenced-by-count":1,"title":["Upadacitinib as a potential option for the management of paradoxical eczema induced by interleukin-23 inhibitors"],"prefix":"10.4081","author":[{"given":"Anna Paola","family":"Lugli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Gori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ippoliti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Ambrosio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketty","family":"Peris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"35901","doi-asserted-by":"crossref","unstructured":"1. Murphy MJ, Cohen JM, Vesely MD, et al. Paradoxical eruptions to targeted therapies in dermatology: A systematic review and analysis. J Am Acad Dermatol 2022;86:1080-91.","DOI":"10.1016\/j.jaad.2020.12.010"},{"key":"35902","doi-asserted-by":"crossref","unstructured":"2. Al-Janabi A, Alabas OA, Yiu ZZN, et al. Risk of Paradoxical Eczema in Patients Receiving Biologics for Psoriasis. JAMA Dermatol 2024;160:71-9.","DOI":"10.1001\/jamadermatol.2023.4846"},{"key":"35903","doi-asserted-by":"crossref","unstructured":"3. Reyn B, Hillary T, Gils A. Eczematous eruption after guselkumab treatment for psoriasis. JAAD Case Rep 2019;5:973-5.","DOI":"10.1016\/j.jdcr.2019.09.005"},{"key":"35904","doi-asserted-by":"crossref","unstructured":"4. Caldarola G, Pirro F, Di Stefani A, et al. Clinical and histopathological characterization of eczematous eruptions occurring in course of anti-IL-17 treatment: a case series and review of the literature. Expert Opin Biol Ther 2020;20:665-72.","DOI":"10.1080\/14712598.2020.1727439"},{"key":"35905","doi-asserted-by":"crossref","unstructured":"5. Al-Janabi A, Martin P, Simpson C, et al. Blood Single-Cell Transcriptomic and Proteomic Signatures of Paradoxical Eczema in Patients with Psoriasis Treated with Biologics. J Invest Dermatol 2025;145:2535-48.","DOI":"10.1016\/j.jid.2025.02.153"},{"key":"35906","doi-asserted-by":"crossref","unstructured":"6. Guttman-Yassky E, Teixeira HD, Simpson EL, et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): results from two replicate double-blind, randomised controlled phase 3 trials. Lancet 2021;397:2151-68. Erratum in: Lancet 2021;397:2150.","DOI":"10.1016\/S0140-6736(21)00588-2"},{"key":"35907","doi-asserted-by":"crossref","unstructured":"7. Chiricozzi A, Ortoncelli M, Schena D, et al. Long-term Effectiveness and Safety of Upadacitinib for Atopic Dermatitis in a Real-world Setting: An Interim Analysis Through 48 Weeks of Observation. Am J Clin Dermatol 2023;24:953-61. Erratum in: Am J Clin Dermatol 2023;24:963-4.","DOI":"10.1007\/s40257-023-00798-0"},{"key":"35908","doi-asserted-by":"crossref","unstructured":"8. Megna M, Potestio L, Ruggiero A, et al. JAK Inhibitors in Psoriatic Disease. Clin Cosmet Investig Dermatol 2023;16:3129-45.","DOI":"10.2147\/CCID.S433367"},{"key":"35909","doi-asserted-by":"crossref","unstructured":"9. Moreno-Davila H, Gamez-Siller P, Franco-Marquez R, et al. Eczematous reaction to guselkumab successfully treated with upadacitinib. J Eur Acad Dermatol Venereol 2025.","DOI":"10.1111\/jdv.20857"}],"container-title":["Dermatology Reports"],"original-title":[],"link":[{"URL":"https:\/\/journals.pagepress.net\/dr\/article\/download\/10644\/9860","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.pagepress.net\/dr\/article\/download\/10644\/9860","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T14:50:56Z","timestamp":1770130256000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.pagepress.net\/dr\/article\/view\/10644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":9,"URL":"https:\/\/doi.org\/10.4081\/dr.2026.10644","relation":{},"ISSN":["2036-7406","2036-7392"],"issn-type":[{"value":"2036-7406","type":"electronic"},{"value":"2036-7392","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,3]]}}}