JAAD Case Report
Dupilumab treatment for atopic dermatitis leading to unexpected treatment for alopecia universalis
Dema T. Alniemi, MD and Laura McGevna, MD
This article reports a case of a 49 year old lady with refractory atopic dermatitis since childhood who was treated with subcutaneous Dupilumab 600mg loading dose, followed by 300 mg every other week. She had concomitant alopecia universalis for 6 years.
The atopic dermatitis and quality of life improved significantly with Dupilumab. At the same time, immediate hair regrowth noted on the scalp. After 8 months of treatment there were full hair regrowth. Some regrowth were seen in eyebrows, but not at other parts of body.
Author reports that both atopic dermatitis and alopecia areata have similar robust helper T cell 2–mediated cytokine pathways with downstream effects manifesting in the skin, it is understandable that dupilumab, a monoclonal antibody that inhibits interleukin (IL)-4 and IL-13, would have effects on both diseases. Dupilumab had been recently reported to be effective in a patient with atopic dermatitis and concomitant alopecia areata. This is the second reported case, to the best of the author’s knowledge, that may indicate the promising result of dupilumab in treating alopecia universalis, totalis, and areata, along with the already known positive effect on atopic dermatitis. They suggest further and larger studies will be needed to fully assess the effects of dupilumab on diseases shared by the helper T cell 2 pathway, as a recent case have emerged of alopecia areata onset after treatment of atopic dermatitis with dupilumab.