Original articleThe impact of dupilumab on patch testing and the prevalence of comorbid allergic contact dermatitis in recalcitrant atopic dermatitis: A retrospective chart review
Section snippets
Study population
This study involved retrospective data collection from electronic medical records of patients receiving 300 mg subcutaneous dupilumab for the management of AD between 2017 and 2019. Only patients with a primary dermatologic diagnosis of moderate-to-severe AD were studied. We collected demographics and relevant medical history, including age, sex, history of conjunctivitis or blepharitis, childhood atopy, comorbid dermatologic diagnoses, and treatment history of AD.
Effectiveness of dupilumab in our study population
The effectiveness of dupilumab
Study population
Forty-eight patients were receiving dupilumab at the time of data collection. The population consisted of adults between 17 and 92 years of age (average 45 years of age; 24 males, 24 females) and a high rate of childhood atopy (68%), defined in this study as the presence of AD, asthma, or hay fever in childhood. Six (12.5%) patients had a comorbid diagnosis of lichen simplex chronicus or prurigo nodularis (LSC/PN), 5 (10.4%) patients had nummular dermatitis (ND), and 4 (8.3%) patients had
The effect of dupilumab on patch testing
Dupilumab did not appear to overtly affect patch test results. An allergic reaction was lost—meaning definitively positive before dupilumab and definitively negative while on dupilumab—in only 13 (10.4%) patch tests pairs out of 125 (Table IV). Although a few reactions were not nonreproduced on dupilumab, most reactions were conserved, suggesting that dupilumab does not usually exert a uniformly dampening effect on ACD.
No particular allergen or allergen class appeared to be dependably blocked
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Funding sources: None.
Conflicts of interest: Dr Murase has participated in advisory boards for Genzyme/Sanofi, Dermira, and UCB, participated in disease statement management talks for Regeneron and UCB, and has provided dermatologic consulting services for Ferndale and UpToDate.