Apruritic Scabies Presenting on IL-31 Blockade with Nemolizumab: A Case Report

Nemolizumab is, a humanized IgG2 monoclonal antibody that inhibits interleukin-31 signaling by binding to the interleukin-31 RA receptor alpha and a first in class IL-31 receptor A antagonist, has proven been effective at reducing pruritis and objective skin signs ion atopic dermatitis and nodular prurigo. in reducing pruritus in patients with atopic dermatitis. However, by suppressing itch, nemolizumab may also delay the presentation of pruritic skin conditions such as scabies, potentially complicating diagnosis. This case highlights a patient who developed a late presentation of scabies while on long-term nemolizumab therapy. The delayed pruritic response to scabies, likely due to the suppression of itch by nemolizumab, underscores the need for thorough dermatological evaluation