Immediate exacerbation of atopic dermatitis after switching from upadacitinib to dupilumab: A report of two cases

Janus kinase (JAK) inhibitors are efficacious for atopic dermatitis (AD). However, some patients receiving JAK develop acne, especially younger patients, or herpes zoster, elderly and desire to switch dupilumab. We experienced two with immediate exacerbation of AD after switching from upadacitinib dupilumab, herein report these cases. This phenomenon is attributed the difference in elimination half-life drugs a slower onset efficacy dupilumab than upadacitinib. When inhibitor short-term concomitant use, intensifying topical treatment, and/or rescue cyclosporine should be considered.