Many Americans suffer from long-term inflammatory skin disorders that have no known etiology and frequently no effective treatments other than symptom control. A recent study may open the door to personalized treatment and diagnostic tests based on precision medicine.
Their findings were published in the journal Scientific Reports.
We isolated individual circulating blood cells and created a new blood test using flow cytometry to identify specific cytokine signatures,
Peripheral blood flow cytometry-based immunophenotyping enabled us to identify a novel form of a severe and potentially life-threatening skin disease.
Shawn Kwatra
The majority of the body’s skin is irritated by erythroderma, a rare yet serious and potentially fatal condition. The skin peels (sloughs) off as a result of the redness and scaling that spread throughout the body. Serious consequences may result from this, including issues with the body’s capacity to regulate temperature and loss of fluid and protein.
Dr. Kwatra and his team immunophenotyped skin illnesses using a novel flow cytometry platform technique, for which they were granted a patent, in order to identify which immune system components were responsible for the inflammatory condition. They discovered that this patient had higher levels of two of these cytokines, interleukin-13 and interleukin-17, than both healthy controls and patients with other recognized causes of erythroderma. The patient’s condition was subsequently reversed by targeted therapy with biologic inhibitors of IL-13 and IL-17.
We found a new role for interleukin-13 and interleukin-17 in the blood samples taken from this patient which supported the use of those two particular medications,
These cytokines appeared to be the key cytokines in defining the disease.
Hannah Cornman
The patient’s symptoms significantly subsided and ultimately disappeared after receiving dual therapy consisting of dupilumab and secukinumab, two monoclonal antibodies, effectively curing him of his erythroderma. Along with tracking the decrease in immunopathogenic (disease-causing) cell counts and the drop in interleukin-13 and interleukin-17 levels in the patient’s blood over the course of treatment, the authors also pinpointed the cell origins of these pathological cytokines.
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We created a new diagnostic test to discover a previously undescribed skin disease and initiate appropriate treatment. We are now exploring developing our diagnostic test to a range of other inflammatory skin.
Shawn Kwatra
This research represents a promising first step towards the development of sophisticated diagnostic tools that employ immunophenotyping to pinpoint the causes of non-specific inflammatory conditions. Patients with these conditions urgently need access to precision-based therapies to help them better manage their symptoms and lead productive lives.
Mark T. Gladwin
Source: University of Maryland – News
Journal Reference: Cornman, Hannah L., et al. “Targeted Dual Biologic Therapy for Erythroderma of Unknown Etiology Guided by High-parameter Peripheral Blood Immunophenotyping.” Scientific Reports, vol. 15, no. 1, 2025, pp. 1-14, https://doi.org/10.1038/s41598-024-81060-3.
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