Exacerbation of Head and Neck Dermatitis in Patients Treated for Eczema With Dupilumab
The efficacy and safety of dupilumab, a humanized monoclonal antibody targeting the α subunit of the interleukin (IL)-4 and IL-13 receptors, has been assessed in adults with moderate-to-severe atopic dermatitis (AD).1,2 Injection site reactions, nasopharyngitis, conjunctivitis, and transient increases in eosinophil counts from baseline were higher in the dupilumab groups than in the placebo groups in pivotal studies.1,2 A recent study by Zhu et al3 reported new regional dermatoses in 17 patients with AD treated with dupilumab, with facial area involvement in 14 cases, whereas Blauvelt et al4 reported an equal improvement of AD with dupilumab on different anatomic regions in a post hoc analysis of data extracted from 4 phase 3 clinical trials.
The patients’ clinical characteristics are reported in the Table. The average age was 38.6 years (range, 19-67 years); most patients were men (26; 62%) and were diagnosed with AD during infancy or childhood (36; 86%). Among these 42 patients, 18 (43%) had ocular involvement before dupilumab therapy. The HN-D occurred 65.4 days (range, 5-365 days) after initiating dupilumab therapy. Twenty patients (48%) had concomitant ocular adverse effects under dupilumab treatment (mainly conjunctivitis).
