Abstract
Atopic dermatitis (AD) in liver transplant (LT) recipients is well-documented, despite frequent use of immunosuppressants in these patients. In a liver transplant population, the prevalence of AD in children and adults is 27.6% and 10.3%, respectively.1 However, there is dearth ofliterature regardingtreatment of this population, and standard regimens are not well-defined.2-4 Here, we report a case of successful treatment of AD in an orthotopic LT patient with dupilumab.
Highlights
Atopic dermatitis (AD) in liver transplant (LT) recipients is well-documented, despite frequent use of immunosuppressants in these patients
We report a case of successful treatment of AD in an orthotopic LT patient with dupilumab
Medical history was significant for hypertension, gastroesophageal reflux, and orthotopic liver transplantation 17 years prior for which she was receiving tacrolimus
Summary
Atopic dermatitis (AD) in liver transplant (LT) recipients is well-documented, despite frequent use of immunosuppressants in these patients. We report a case of successful treatment of AD in an orthotopic LT patient with dupilumab. Medical history was significant for hypertension, gastroesophageal reflux, and orthotopic liver transplantation 17 years prior for which she was receiving tacrolimus. Phototherapy was relatively contraindicated secondary to patch-test proven concomitant photoallergic contact dermatitis. After discussion with the patient’s care team, the patient was started on a dupilumab regimen for persistent atopic dermatitis, with an initial loading dose of 600 milligrams followed by 300 milligrams every two weeks. The hepatic function panel and immunosuppressant levels were monitored monthly for three months, every three months after initiation of dupilumab. Treatment was welltolerated and no issues with hepatic function, immunosuppressant levels, or graft-related complications were reported
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