First, do no harm: The urgent need for comprehensive clinical guidelines for diagnostic testing of recalcitrant “atopic dermatitis”

Abstract

To the Editor: We thoroughly agree with the authors that exploring options for diagnostic testing of eczematous dermatitis, including but not limited to biopsy, flow cytometry, and molecular testing, should be considered in patients with atopic dermatitis (AD) with an inadequate response to dupilumab. To that end, in a publication authored by Murase and colleagues, we outlined clinical and diagnostic pearls to assist clinicians in identifying cutaneous T cell lymphoma (CTCL), given this form of lymphoma often poses a diagnostic challenge for dermatologists due to its insidious presentation and mimicry of benign eczematous disorders.