How Long Does It Take Dupixent To Work For Eczema

How Long Does It Take Dupixent To Work For Eczema – Atopic dermatitis is a chronic inflammatory skin disease that affects one fifth of the population in developed countries.

It is characterized by the frequent appearance of itching and plaque with discharge, exfoliation, scaling, fissures and lichenization in the later stages.

How Long Does It Take Dupixent To Work For Eczema

How Long Does It Take Dupixent To Work For Eczema

Atopic dermatitis lesions can be very itchy and uncomfortable. African Americans have a 19.3% and 16.1% incidence of atopic dermatitis compared to their Caucasian counterparts.

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In addition, atopic dermatitis can be more severe in patients with skin of color, and black and Hispanic children are more likely to persist into adulthood.

Atopic dermatitis in the skin of patients of color can be troublesome due to post-inflammatory hyperpigmentation, which often leads to psychological effects and negative effects on quality of life and productivity.

We report a case in which intensive treatment of atopic dermatitis in an African-American patient not only improved clinical areas of atopic dermatitis and post-inflammatory hyperpigmentation, but also improved hyperpigmentation in the affected skin.

A 53-year-old African American man presented with a 1-year history of worsening pruritus. He was spraying Vaseline without relief. Past medical history was significant for deafness and iron deficiency. Physical examination showed multiple hyperpigmented plaques, hyperpigmented lichen plaques and hyperpigmented spots on the body, limbs, joints, neck and face. The patient was diagnosed with moderate atopic dermatitis. Triamcinolone 0.1, tacrolimus 1% and cetirizine 20 mg per day were prescribed. Skin care and soaking and exfoliation techniques were reviewed. Two months later, the patient received a loading dose of 600 mg dupilumab. After two weeks, the patient’s atopic dermatitis and pruritus improved (Figure 1). The patient continued on 200 mg subcutaneously every 2 weeks, which resulted in persistent atopic dermatitis, postinflammatory hyperpigmentation, and marked hyperpigmentation in the affected areas (Figures 2 and 3). Skin care regimen is emphasized with intermittent use of 0.1% triamcinolone ointment or 1% tacrolimus ointment as needed for pruritus. After the completion of the fifth month, the next 200 mg injection was given every 3 weeks instead of 2 weeks. Her atopic dermatitis developed with itching during this time. Dupilumab frequency was reset every 2 weeks. Atopic dermatitis flares resolved and post-inflammatory hyperpigmentation improved (Figure 4).

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Atopic dermatitis and post-inflammatory hyperpigmentation are among the five most common skin complaints seen by dermatologists in patients of color. A study of patients referred to the Skin Color Center at St. Luke’s Roosevelt Hospital Center in New York City found that dyschromia, including postinflammatory hyperpigmentation, was the second most common diagnosis in African-American patients. It was not even among the top ten diagnoses for Caucasian patients.

Atopic dermatitis often results in post-inflammatory pigmentary changes, often post-inflammatory hyperpigmentation, in fair-skinned individuals.

This strongly suggests increased melanocyte function and explains why inflammatory conditions such as atopic dermatitis cause hyperpigmentation. Post-inflammatory hyperpigmentation is more persistent and clinically evident in patients with darker skin color.

How Long Does It Take Dupixent To Work For Eczema

Dupilumab is a monoclonal antibody that blocks the IL-4 alpha receptor, thereby inhibiting IL-4 and IL-13 signaling and preventing the release of type 2 cytokines that cause inflammation in atopic dermatitis. to be

Dupilumab: A Milestone In The Treatment Of Atopic Dermatitis

A randomized controlled trial of 54 patients treated with dupilumab resulted in a reduction in cellular filters and significant clinical improvement.

In this case, the post-inflammatory hyperpigmentation was very severe. After initiation of dupilumab, clinical improvement of post-inflammatory hyperpigmentation and lightening of overall skin color was observed. Suarez et al. compared sensitized skin from atopic dermatitis, sensitized skin and normal skin sampling and found that sensitized skin has T cell proliferation.

Abnormalities seen in atopic skin are also seen in vulnerable skin, suggesting that the total body surface area of ​​the skin in patients with atopic dermatitis is abnormal, even if it appears clinically normal.

This is especially important in patients with pigmented skin who are prone to the residual effects of atopic dermatitis, such as post-inflammatory hyperpigmentation.

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Systemic treatment of moderate to severe atopic dermatitis with dupilumab in pigmented skin should be considered in patients with significant and worrisome hyperpigmentation. Reducing hyperpigmentation in clinically evident areas of atopic dermatitis and post-inflammatory hyperpigmentation can improve quality of life. For patients with pigmented skin, aggressive treatment with duplimumab may accelerate the return of the patient’s overall skin color.

Post-inflammatory hyperpigmentation often occurs with psychosocial disorders. A study that assessed quality of life found that patients with atopic dermatitis reported significantly more mood and sleep disturbances compared to control patients.

In a study of 419 patients, those with post-inflammatory hyperpigmentation had higher Dermatology Life Quality Index (DLQI) scores, indicating poorer quality of life, compared to patients with other hyperpigmentation disorders.

How Long Does It Take Dupixent To Work For Eczema

In addition, this study showed that DLQI scores were higher in women and young adults over 35 years of age. Having a postgraduate education was associated with a significantly lower DLQI score, indicating that patients with a lower level of education have a more negative impact on quality of life.

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Atopic dermatitis is a systemic disease. The effect of dupilumab on post-inflammatory hyperpigmentation and visible hyperpigmentation in sensitive skin highlights the scientific data on the activity of atopic dermatitis in sensitive and non-sensitive skin. When considering aggressive treatment of atopic dermatitis, the overall impact of the disease, including psychosocial burden, post-inflammatory hyperpigmentation and, in some cases, generalized skin hyperpigmentation, must be considered. Patients with atopic dermatitis experience high levels of anxiety, depression, sleep disorders and reduced work productivity.

In addition, post-inflammatory hyperpigmentation can have a negative impact on quality of life. The burden of atopic dermatitis in patients with skin of color goes beyond itching. In our case, aggressive treatment with dupilumab resulted in improvement of visible hyperpigmentation in clinically sensitive skin (but scientifically sensitive skin), postinflammatory hyperpigmentation, and atopic dermatitis.

3. Fu T, Keizer E, Linos E, et al. Eczema and sensitization to common allergens in the United States: a multinational population-based study of children Dermatol. 2014; 31:21-26.

4. Kim Y, Blomberg M, Rifas-Shiman SL, et al. Racial/ethnic differences in the incidence and duration of childhood atopic dermatitis. J Invest Dermatol. 2019; 139:827e34.

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5. Eckert L, Gupta S, Amanda S, et al. Impact of atopic dermatitis on health-related quality of life and productivity in US adults: an analysis using the National Survey on Health and Well-Being. J Am Acad Dermatol. 2017; 77 (2): 274-79.e3.

6. Suarez-Fariñas M, Tintle S, Shemer A, et al. Atopic dermatitis (AD) is characterized by widespread terminal differentiation defects and variable immunodeficiencies. J Allergy Clin Immunol. 2011; 127:954-64.e1-4. doi: 10.1016/j.jaci.2010.12.1124.

7. Alexis AF, Sergey AB, Taylor SC. Common skin problems in skin of color: a comparative study of cutis. 2007; 80:387-94.

How Long Does It Take Dupixent To Work For Eczema

8. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010; 3 (7): 20-31.

Dupixent For Eczema

10. Taylor S, Grimes P, Lim J, et al. Postinflammatory hyperpigmentation J Cutan Med Surg. 2009; 3: 183-191. doi: 10.2310/7750.2009.08077.

11. Guttman-Jassky E, Bissonnette R, Ungar B, et al. Dupilumab improves systemic and skin abnormalities in patients with atopic dermatitis. J Allergy Clin Immunol. 2019; 143:155-172.

12. Maymone MBC, Neamah HH, Wirya SA, et al. (2017). Impact of skin hyperpigmentation and hyperchromia on quality of life: a cross-sectional study. J Am Acad Dermatol. 2017; 77:775-778. doi: 10.1016/j.jaad.2017.05.009.

Grayson, K., and Heath, K.R. (2020). Dupilumab improves atopic dermatitis and post-inflammatory hyperpigmentation in patients with pigmented skin. Journal of Drugs in Dermatology: JDD, 19(7), 776-778.

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The Journal of Drugs in Dermatology is available to US dermatologists, US dermatology residents, and US dermatology NPs/PAs. Create an account at JDDonline.com and access 15 years of archived PubMed/MEDLINE content. Chronic skin diseases such as eczema and psoriasis are among the most common health problems. In addition to severe dryness, itching and pain, eczema, psoriasis and similar conditions can have a direct impact on quality of life and lead to reduced self-esteem and/or depression. And worse, the treatment of these diseases is very expensive.

In 2017, the FDA approved a new injectable treatment for moderate to severe eczema called Dupixent. This medication contains an antibody that binds to a protein to prevent the immune system’s inflammatory response that causes the redness, itching, and irritation associated with eczema.

Dupixent is a significant departure from traditional eczema treatments, which usually involve regular topical application of creams and medications, and based on research results, the injection method appears to be more effective for some.

How Long Does It Take Dupixent To Work For Eczema

CBS News reported that study participant Ashley Blois was using Dupixent to help her return to her normal life. Before taking the medication, Blois had to apply ice packs to her skin at night to reduce the itching, but she still suffered from insomnia. He would even change clothes in his car so his freckles would bleed through his clothes.

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It didn’t take long for Dupixent’s effects to appear. Blois’ symptoms improved several months after the start of the study. Two years later she still only has a few patches of eczema and no itching.

It’s not just eczema patients who claim to see results from this drug. Dr. Elaine Siegfried, professor of pediatrics and dermatology at St. Louis University School of Medicine, reports that Dupixent works.

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