Treatment of Severe Recalcitrant Atopic Dermatitis with Dupilumab in a Kidney Transplant Patient

Vivian Li, Sophie Guenin, M. Lebwohl
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Abstract

This case report highlights the successful treatment of refractory atopic dermatitis (AD) in an immunosuppressed patient using dupilumab, a biologic agent that selectively targets cytokines crucial in the pathogenesis of AD. The patient had a history of failed treatment with numerous topical and systemic immunomodulating agents, including corticosteroids and immunosuppressive drugs for organ transplant. Dupilumab treatment resulted in significant improvement of symptoms, including reduced pruritus, and ultimately achieved disease control. Importantly, the patient experienced no adverse effects apart from one COVID-19 infection over three years of co-administration of dupilumab with immunosuppressive transplant rejection treatment. The safety of dupilumab in immunocompromised and transplant patients has been a concern, but studies have shown its safety and efficacy in these patient populations. This case highlights the potential for dupilumab as a safe and effective treatment option for patients with severe AD who are immunocompromised or have undergone solid organ transplantation.   
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杜匹单抗治疗肾移植患者严重难治性特应性皮炎
本病例报告强调了使用dupilumab成功治疗免疫抑制患者的难治性特应性皮炎(AD), dupilumab是一种选择性靶向在AD发病机制中至关重要的细胞因子的生物制剂。患者有大量局部和全身免疫调节剂治疗失败的历史,包括用于器官移植的皮质类固醇和免疫抑制药物。Dupilumab治疗导致症状显著改善,包括瘙痒减轻,并最终实现疾病控制。重要的是,在dupilumab与免疫抑制移植排斥治疗联合使用的三年中,除了一次COVID-19感染外,患者没有出现任何不良反应。dupilumab在免疫功能低下和移植患者中的安全性一直是一个问题,但研究表明其在这些患者群体中的安全性和有效性。该病例强调了dupilumab作为免疫功能低下或接受实体器官移植的严重AD患者安全有效的治疗选择的潜力。
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