Abstract:

Objective To observe the efficacy of dupilumab in the treatment of refractory atopic dermatitis （AD），and to provide the reference for the treatment of such patients. Methods The clinical data and follow-up results of two patients with refractory severe AD treated with dupilumab were collected；combined with the literature review， the efficacy and safety of dupilumab in the treatment of refractory AD were analyzed. Results Patient 1 was a 30-year-old female with dense， infiltrated papules on the back of both hands， resembling lichenified skin changes， scattered erythema， and papules with itching on the limbs and trunk for 25 years. Patient 1 also had a history of allergic rhinitis for 5 years. The diagnosis was adults severe AD. After 16 weeks of treatment with dupilumab， the skin lesions were completely regressed， and there were no relapse during the follow-up period. The symptoms of allergic rhinitis was improved significantly， and oral medication was no longer needed. Patient 2 was a 59-year-old female with general dark red erythema， papules， and nodules accompanied by itching for over 10 years. Patient 2 had been hospitalized many times and had previously received treatment with cyclosporine， azathioprine， and steroids with unsatisfactory results. The diagnosis was adults severe AD. Up to the present， the skin lesions had essentially regressed after treatment with dupilumab. Conclusion Dupilumab has good curative effect and safety on refractory AD，and it can improve the life quality， and controll the charicteristics of AD complicated with other allergic diseases driven by type 2 inflammation.

Key words: Atopic dermatitis, Dupilumab, Papules, Allergic rhinitis, Efficacy