13937 Dupilumab for the treatment of dyshidrotic eczema: A multi-institution experience of 15 consecutive patients

Abstract

Dupilumab is a human monoclonal antibody that is approved for the treatment of atopic dermatitis. Several case reports and small case series (≤3 patients) have reported using dupilumab in the treatment of dyshidrotic eczema; however, data supporting dupilumab’s use in this condition is still limited. To highlight the role of dupilumab in dyshidrotic eczema we present a series of 15 consecutive patients from three institutions treated with dupilumab for dyshidrosis. Patients with eczema only on hands and/or feet were included. All patients initially received atopic dermatitis dosing of dupilumab. Demographics are as follows: 10 males, 5 females, average age 56 (range 32-76). All patients had previously failed topical corticosteroids and 11/15 patients had previously failed at least one oral immunosuppressive and/or phototherapy. All patients demonstrated at least partial response to dupilumab with 6 patients clearing. 14/15 patients started on dupilumab for dyshidrotic eczema are still on dupilumab with an average treatment duration of 12.5 months. 7 patients have been on dupilumab for more than one year. The one patient in our cohort who stopped dupilumab was responding appropriately but decided to discontinue because she was concerned about possible side-effects. Dupilumab was well tolerated in our cohort with only 3 reported adverse events. One patient developed conjunctivitis that is being managed satisfactorily with artificial tears. Two patients developed dupilumab facial redness that was refractory to treatment with topical corticosteroids, topical azoles, and topical calcineurin inhibitors. Our series suggests that dupilumab is a generally well tolerated and frequently effective treatment for dyshidrotic eczema.