Background Malignant atrophic papulosis (MAP) is the systemic subtype of Degos disease, characterized by high lethality. Currently there is no standardized treatment protocol. Steroids and immunosuppressive therapies result in limited effectiveness. Biologic treatments offer promising therapeutic potential for MAP and significantly improve prognosis. Aims This review aims to systematically evaluate the applications of various biologics in the treatment of MAP and to explore their potential efficacy. Methods We systematically searched three electronic databases (Scopus, Embase, and PubMed) from inception to November 30, 2025. All cases involving biologics for the treatment of MAP were included and analyzed. Results A total of six different biologics have been utilized in the treatment of MAP. Among all the biologics, eculizumab demonstrated the highest response rate, reaching 76.5% ( n = 13/17). The use of rituximab has yielded inconsistent outcomes in the treatment of MAP. Neither tocilizumab nor natalizumab demonstrated satisfactory therapeutic efficacy, while the use of TNF inhibitors may result in disease exacerbation. Conclusion Eculizumab is recommended as a potential salvage therapy, and its combination with treprostinil may result in longer disease remission time. TNF inhibitors should be avoided in patients with MAP. More studies are needed to assess the long‐term safety and efficacy of biologics in the treatment of MAP.
Liu et al. (2026) studied this question.