Pityriasis rosea during omalizumab treatment for chronic spontaneous urticaria.


Journal

Dermatologic therapy
ISSN: 1529-8019
Titre abrégé: Dermatol Ther
Pays: United States
ID NLM: 9700070

Informations de publication

Date de publication:
11 2020
Historique:
received: 02 09 2020
revised: 24 09 2020
accepted: 27 09 2020
pubmed: 4 10 2020
medline: 15 5 2021
entrez: 3 10 2020
Statut: ppublish

Résumé

Pityriasis rosea (PR) is an exanthematous disease whose etiology is related to reactivation of herpes human herpesviruses 6 (HHV-6) and 7 (HHV-7). We observed two cases of PR arising during omalizumab therapy for chronic spontaneous urticaria (CSU). Here we report for the first time PR occurring during omalizumab treatment. After PR diagnosis, viral serology was performed. Data in literature about omalizumab mechanism of action, PR and HHV-6/7 infection were analyzed in order to identify possible correlations. In both our cases IgM against HHV-6 and HHV-7 were negative. The first patient presented altered IgG titers for both viruses (1:160 and 1:80, respectively) while only HHV-6 IgG (1:320) were detected in the second patient. From data in literature, we consider it presumable that apoptotic immune cells due to omalizumab immunomodulation could release viral proteins produced from integrated DNA. This could elicit cutaneous cross-reactivity and PR onset. In conclusion, we think there is a link between omalizumab therapy and PR occurring in patients with CSU. Our case history is too small to draw firm conclusions. Data collection of similar cases could be helpful to improve our knowledge.

Identifiants

pubmed: 33009684
doi: 10.1111/dth.14356
doi:

Substances chimiques

Anti-Allergic Agents 0
Omalizumab 2P471X1Z11

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e14356

Informations de copyright

© 2020 Wiley Periodicals LLC.

Références

Drago F, Ciccarese G, Rebora A, Broccolo F, Parodi A. Pityriasis rosea: a comprehensive classification. Dermatology. 2016;232(4):431-437.
Broccolo F, Drago F, Careddu AM, et al. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J Invest Dermatol. 2005;124(6):1234-1240.
Drago F, Broccolo F, Rebora A. Pityriasis rosea: an update with a critical appraisal of its possible herpesviral etiology. J Am Acad Dermatol. 2009;61:303-318.
Watanabe T, Kawamura T, Jacob SE, et al. Pityriasis rosea is associated with systemic active infection with both human herpesvirus-7 and human herpesvirus-6. J Invest Dermatol. 2002;119:793-797.
Kosuge H, Tanaka-Taya K, Miyoshi H, et al. Epidemiological study of human herpesvirus-6 and human herpesvirus-7 in pityriasis rosea. Br J Dermatol. 2000;143:795-798.
Drago F, Ciccarese G, Broccolo F, et al. The role of cytokines, chemokines, and growth factors in the pathogenesis of pityriasis rosea. Mediators Inflamm. 2015;2015:438963.
Litchman G, Nair PA, Le JK. Pityriasis Rosea. Treasure Island (FL): StatPearls Publishing; 2020.
Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA2LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393-1414.
Tonacci A, Billeci L, Pioggia G, Navarra M, Gangemi S. Omalizumab for the treatment of chronic idiopathic urticaria: systematic review of the literature. Pharmacotherapy. 2017;37(4):464-480.
Papaianni V, Guarneri F, Vaccaro M, Borgia F, Guarneri C, Cannavò SP. From regulatory limitations to new opportunities: real-life experience on the effectiveness of short courses of omalizumab in the treatment of chronic idiopatic urticaria. Dermatol Ther. 2020;33:e13188.
Dreyfus DH. Serological evidence that activation of ubiquitous human herpesvirus-6 (HHV-6) plays a role in chronic idiopathic/spontaneous urticaria (CIU). Clin Exp Immunol. 2016;183(2):230-238.
Gill MA, Liu AH, Calatroni A, et al. Enhanced plasmacytoid dendritic cell antiviral responses after omalizumab. J Allergy Clin Immunol. 2018;141(5):1735-1743.
Noga O, Hanf G, Brachmann I, Klucken A, Kleine-Tebbe J, et al. Effect of omalizumab treatment on peripheral eosinophil and T-lymphocyte function in patients with allergic asthma. J Allergy Clin Immunol. 2006;117(6):1493-1499.
Luppi M, Barozzi P, Morris C, et al. Human herpesvirus 6 latently infects early bone marrow progenitors in vivo. J Virol. 1999;73(1):754-759.

Auteurs

Mario Vaccaro (M)

Department of Clinical and Experimental Medicine-Dermatology, University of Messina, Messina, Italy.

Ilenia Marafioti (I)

Department of Clinical and Experimental Medicine-Dermatology, University of Messina, Messina, Italy.

Serafinella Patrizia Cannavò (SP)

Department of Clinical and Experimental Medicine-Dermatology, University of Messina, Messina, Italy.

Giulia Ciccarese (G)

Dermatology Unit, Ospedale Policlinico San Martino, Genoa, Italy.

Francesco Drago (F)

Dermatology Unit, Ospedale Policlinico San Martino, Genoa, Italy.
DI.S.Sal., Section of Dermatology, University of Genoa, Genoa, Italy.

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