Effective use of dupilumab in managing systemic allergic contact dermatitis
Abstract
Allergic contact dermatitis to metals has become increasingly recognized in patients with endovascular implants. The ACD can lead to in-stent restenosis as well as a prominent eczematous reaction overlying the implant, often necessitating its removal. We present a case of refractory allergic contact dermatitis to nickel in a 44-year-old man with numerous endovascular stents and vascular clips. He developed numerous adverse effects of systemic therapy to manage his symptoms including recurrent infections leading to frequent hospitalizations. He was effectively transitioned to dupilumab, a monoclonal antibody against the IL-4α subunit currently approved by the Food and Drug Administration in the management of atopic dermatitis, with an improvement in symptoms and a reduction in infection rate.
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There have been multiple reports demonstrating the effectiveness of dupilumab in the treatment of ACD.
“There have been multiple reports demonstrating the effectiveness of dupilumab in the treatment of ACD (eTable).[12][13][14][15][16][17][18][19][20]”
From Dupilumab for Allergic Contact Dermatitis: An Overview of Its Use and Impact on Patch Testing. (2022) · cites this paper as [12]
Findings from these studies show that dupilumab can improve recalcitrant dermatitis caused by a broad range of contact allergens, including nickel.
“The findings from these studies show that dupilumab can improve recalcitrant dermatitis caused by a broad range of contact allergens, including nickel.”
From Dupilumab for Allergic Contact Dermatitis: An Overview of Its Use and Impact on Patch Testing. (2022) · cites this paper as [12]
Several studies have reported successful use of dupilumab for systemic ACD.
“Notably, several studies have reported successful use of dupilumab for systemic ACD.12,18”
From Dupilumab for Allergic Contact Dermatitis: An Overview of Its Use and Impact on Patch Testing. (2022) · cites this paper as [12]
Cites
Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis
Simpson, E. L., Bieber, T., Guttman-Yassky, E., Beck, L. A., Blauvelt, A., Cork, M. J., Silverberg, J. I., Deleuran, M., Kataoka, Y., Lacour, J.-P., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1610020 · Cited by 2,110 · see citing works
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Dupilumab for Allergic Contact Dermatitis: An Overview of Its Use and Impact on Patch Testing.
Johnson, H. (2022) · Current Psychiatry · doi:10.12788/cutis.0519 · Cited by 20 · see citing works
- Authors
- Joshi, S. R., & Khan, D. A.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Venue
- Dermatitis®
- Publisher
- SAGE Publications
- Published
- 2018-10-01
- Volume
- 29
- Issue
- 5
- Pages
- 282-284
- ISSN
- 1710-3568 (ISSN-L)
- 2162-5220
- OpenAlex
- W2889194084
- Cited by
- 58
- References
- 1
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 7 · 2021: 12 · 2020: 8 · 2019: 10 · 2018: 1
- FWCI
- 8.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Dermatitis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
- Keywords
- dupilumab, allergic contact dermatitis, nickel allergy, endovascular stents, vascular clips, in-stent restenosis, refractory eczema, IL-4 receptor alpha blockade, infection reduction, monoclonal antibody therapy
- MeSH terms
- Adult, Allergens, Anti-Inflammatory Agents, Antibodies, Monoclonal, Humans, Male, Nickel, Interleukin-4, Dermatitis, Allergic Contact, Antibodies, Monoclonal, Humanized
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