Erythrodermic Psoriasis in the Context of Emerging Triggers: Insights into Dupilumab-Associated and COVID-19-Induced Psoriatic Disease

    June 2025 in “ Dermatopathology ”
    Aya Fadel, Jayakumar Nithura, Zahraa F. Saadoon, Lamia Naseer, Angelo Lopez-Lacayo, L Solano, Carmelo Morales‐Angulo, Robert J. Hernandez, Hussain Hussain
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    Studysummary This study reports that SARS-CoV-2 infection, COVID-19 vaccination, and off-label dupilumab treatment may exacerbate psoriasis, with overlapping inflammatory pathways involving cytokines like IL-17 and TNF-α. Histopathological similarities between psoriasis flares and COVID-19 skin manifestations were noted, suggesting a potential connection requiring further research. Our plain-language summary of this paper — not a Tressless recommendation.
    This study investigates the potential triggers of erythrodermic psoriasis (EP), particularly focusing on the roles of SARS-CoV-2, COVID-19 vaccination, and dupilumab therapy. It presents a case of a 70-year-old male who developed EP after starting dupilumab, suggesting that both SARS-CoV-2 and dupilumab may share inflammatory pathways that exacerbate psoriasis. The research highlights the need for further studies to understand these relationships and improve management strategies for complex psoriasis cases. Additionally, it discusses how COVID-19 and its vaccines can exacerbate or induce psoriasis through immune dysregulation, emphasizing the importance of understanding the immunological pathways to enhance treatment strategies.
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