2023 Volume 37 Issue 1 Pages 113-119
Lichenification is a chronic lesion of atopic dermatitis (AD) and results mainly from thickening of the skin due to repeated scratching. Lichenified lesions are usually intractable, and treatment using steroid ointments is invariably challenging. We investigated the efficacy of dupilumab in management of overall skin lesions of the head and neck, upper and lower extremities, and the trunk in patients with childhood-onset AD; we particularly focused on its effects on lichenification.
The study included four patients with AD onset in infancy, in whom dupilumab treatment was initiated at ≥15 years of age. We recorded the Eczema Area and Severity Index (EASI) score for each of the 4 symptoms (Erythema Edema/Papulation Excoriation Lichenification) at the following time points: before, 1 month after, 2 months after, 6 months after, and 12 months after treatment initiation.
Four patients were diagnosed with AD in infancy and continued to receive treatment. The EASI score for lichenification alone at the time of dupilumab initiation ranged from 3.2 to 13.2; however, the EASI score improved within 4 to 12 weeks of drug therapy. EASI scores for manifestations other than lichenification also improved.
Dupilumab effectively treated generalized lichenified skin lesions in patients with childhood-onset AD.
