Successful Therapy with Dupilumab in Prurigo nodularis-2 Case Reports

Abstract

Dupilumab has been approved for the treatment of moderate to severe atopic eczema in adults since September 2017. It has also been approved for other indications such as asthma or allergic rhinoconjuctivitis with nasal polyposis. Dupilumab is a fully human monoclonal antibody directed against the alpha subunit of the interleukin (IL)-4 and IL-13 receptors, hence, inhibiting IL-4/IL-13. Prurigo nodularis (PN) is a hard to treat pruritic skin condition, characterized by pruritic papules and nodules on the trunk and on extremities. Patients suffer from the stinging pruritus and an improvement is hardly achieved despite intensive topical and systemic antipruritic therapy. According to literature, Dupilumab has shown promising anti-pruritic and skinâ clearing effects in patients with prurigo nodularis (PN) with no significant adverse effects. Thus, Dupilumab appears to be safe and well tolerated. However, larger, homogeneous studies are needed to further clarify its safety. Here we describe two case reports with chronic severe atopic dermatitis and secondary PN, one of themcomplicated by sepsis. PN was refractive to other treatments but responded well to treatment with Dupilumab. No side effects have occurred.