Variable impact of dupilumab on patch testing results and allergic contact dermatitis in adults with atopic dermatitis

Abstract

Previous case reports and series suggested that dupilumab may be an effective treatment for allergic contact dermatitis (ACD). Little is known about the impact of dupilumab on patch test results and comorbid ACD in patients with atopic dermatitis (AD). Determine the impact of dupilumab on patch testing results and improvement of ACD in patients with AD. A retrospective study of patients with AD treated with dupilumab who underwent patch testing (n=7) or had concomitant ACD (n=6). In all, 7 patients with AD were patch tested while taking dupilumab; in all of these patients, at least 1 positive patch test reaction was observed, with a total of 25 different allergens having a reaction graded as 1+or stronger and few irritant reactions. In 1 patient, multiple previously positive relevant patch test results were not duplicated upon repeat patch testing. In the 6 patients with AD and concomitant ACD, dupilumab and allergen avoidance resulted in substantial or complete resolution of AD signs and symptoms but resolution of ACD in only 3 patients. However, 3 patients had at least 1 flare of ACD upon re-exposure to relevant allergens. Retrospective and uncontrolled study. Dupilumab had variable impact on patch testing results and resolution of comorbid ACD in adult patients with AD.