Dupilumab is commonly used for atopic dermatitis and other related conditions, and we provide a case series of new onset or worsening vitiligo after initiating dupilumab.Characterized by a type 1 cytokine profile driven by interferon-γ, vitiligo reflects an interplay between genetic predisposition, environmental triggers, melanocyte stress, and both innate and adaptive immune responses.Dupilumab, a human interleukin-4 receptor alpha antagonist, inhibits interleukins-4 and 13, which promote type 2 cytokine inflammation in atopic dermatitis (AD).We present a multicentre report of seven patients with induced or exacerbated vitiligo after starting dupilumab for severe atopic dermatitis or nasal polyposis.Vitiligo affecting the face was most common (4/7 [57.1%]), and none had poliosis of the hair, suggesting a potential pos. treatment response.In summary, vitiligo is a rare adverse reaction to dupilumab, likely affecting those genetically or otherwise predisposed.Treatment, either with topical immunosuppressants or narrow-band UV B (nbUVB) phototherapy, satisfactorily repigmented or stabilized vitiligo, even in those who continued dupilumab.The onset of vitiligo in patients using targeted biologics may indicate that pathogenic cytokines for one disease may actually suppress immune responses that drive other diseases.Thus, we hypothesize that in our cases described above, the use of dupilumab disrupted normal skin homeostasis by blocking type 2 inflammation, which permitted unrestricted type 1 inflammation to increase and induce vitiligo.