Published in Dermatology

Journal Scan / Research · June 08, 2019

A Retrospective Review of Dupilumab for Hand Dermatitis

Dermatology (Basel, Switzerland)




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• This retrospective chart review compared 66 patients treated with dupilumab for at least 3 months for either hand dermatitis only, body and hand dermatitis, or body dermatitis only at a single academic center. After treatment with dupilumab, almost 40% of patients with hand dermatitis achieved an IGA score of 0 or 1 compared with 63.6% of patients with atopic dermatitis but without hand involvement, although a value for statistical significance for this comparison was not provided.

• The results indicate that dupilumab may be a good treatment for hand dermatitis in those who have failed other systemic therapies, with improvement of patient-reported outcomes such as hand fissuring, sleep disturbance, and pruritus. Further studies comparing the efficacy of dupilumab for hand dermatitis with dermatitis on the rest of the body are warranted to further investigate the trends indicated in this study.

– Margaret Hammond, MD

Written by

 

 

Stephen E Helms MD

Since dupilumab became available for general use in March 2017, most practitioners have seen patients with severe atopic dermatitis that proved resistant to other topical and systemic therapies who have responded miraculously to this drug. Previous systemic options were limited by their potential for severe complications.

This letter demonstrates that dupilumab can be equally effective for another very difficult problem: chronic hand eczema that has proven to be resistant to topical therapy and/or traditional systemic medications. These patients suffer with pain due to fissuring in addition to itching and dryness, which negatively impacts their quality of life. Overall, this appears to be a very safe medication, although it is expensive! Of course, it is important to exclude patients with palmar dermatitis caused by psoriasis, which would not be expected to respond to a drug that targets TH-2 cytokines. The same is true for allergic contact dermatitis, which should ideally be treated by withdrawal of the inciting allergen.

I agree with the authors' closing remark: "Dupilumab may be a good treatment for patients with hand dermatitis for whom other therapies have failed."

Abstract

Hand dermatitis is a common condition affecting approximately 10% of the population in any given year. Due to its location on the body, hand dermatitis can dramatically impact quality of life by affecting social functioning and the ability to perform activities of daily living. For patients with severe hand dermatitis, topical treatments are often not effective, and systemic therapies are associated with significant risks with long-term use.

Dermatology (Basel, Switzerland)

A Retrospective Review of Dupilumab for Hand Dermatitis

Dermatology (Basel) 2019 May 01;235(3)187-188, N Lee, N Chipalkatti, P Zancanaro, C Kachuk, N Dumont, D Rosmarin 

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.