Treatment of Patients Experiencing Dupilumab Facial Redness With Itraconazole and Fluconazole Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• At a single institution, patients with dupilumab–induced facial redness treated with either oral itraconazole or fluconazole were evaluated. Facial redness occurred in 5.3% of all patients treated with dupilumab and began at an average 8.5 months after treatment initiation. In the itraconazole group, 11 of 16 patients were clear or almost clear up to 6 months later. In contrast, none of the 4 patients treated with fluconazole saw resolution of their symptoms.

• Systemic antifungal therapies appear to be effective in many patients with dupilumab–induced facial redness. While the sample size was small, these findings suggest that itraconazole may be more effective than fluconazole when used for this purpose.

–  Margaret Hammond, MD

Abstract

Dupilumab facial redness (DFR) is a recently described adverse event of dupilumab use.1 Prior cases of treatment with itraconazole have been reported.2 In this retrospective study, we investigated the management of DFR with itraconazole or fluconazole. This study was approved by the Tufts Medical Center (TMC) Institutional Review Board. Patients at TMC Dermatology who were on dupilumab for at least 16 weeks, had a diagnosis of DFR, and completed at least two weeks of daily fluconazole or itraconazole 200 milligrams (mg) were included. Investigator global assessment (IGA) before and after azole use, dupilumab associated ocular surface disease (DOSD), and self-reported improvement (%), obtained from a routine pharmacist phone call two weeks after azole initiation, were recorded. DOSD was defined as irritation, dryness, tearing, or conjunctivitis.

Journal of the American Academy of Dermatology

Treatment of Patients Experiencing Dupilumab Facial Redness With Itraconazole and Fluconazole: A Single Institutional Retrospective Medical Record Review

J Am Acad Dermatol 2021 Mar 25;[EPub Ahead of Print], DX Gao, S Song, JS Kahn, SR Cohen, K Fiumara, N Dumont, D Rosmarin 

Sent from my iPhone

Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

Please excuse the shortness of this message, as it has been sent from
a mobile device.