INTRODUCTION
Inhibition of interleukin (IL)-13, a key mediator of type 2 inflammation, is a highly effective and targeted therapeutic strategy for atopic dermatitis (AD).1 Despite an excellent safety profile, ocular adverse effects are a relatively common cause of treatment discontinuation.1 Here we describe what is, to our knowledge, the first reported case of cicatricial ectropion associated with soluble IL-13 inhibition.
Case Report
An 81-year-old man presented for evaluation of a widespread rash present intermittently since childhood. His history was notable for seasonal allergies and ocular history of cataracts, dry eyes, and epiphora. At the time of evaluation, he was not receiving treatment, although he had previously used multiple topical corticosteroids. Examination revealed eczematous patches and plaques involving 60% body surface area (BSA) and Investigator Global Assessment (IGA) 3, prompting initiation of dupilumab at standard dosing (600 mg loading dose followed by 300 mg every two weeks). Seven months after initiation, he developed pruritus and tearing of both eyes without pain or visual changes. Examination revealed few eczematous papules and plaques involving the scalp, trunk and extremities, BSA 3% and IGA 1, overall, much improved from prior examinations. Ophthalmologic exam showed bilateral upper and lower lid
Case Report
An 81-year-old man presented for evaluation of a widespread rash present intermittently since childhood. His history was notable for seasonal allergies and ocular history of cataracts, dry eyes, and epiphora. At the time of evaluation, he was not receiving treatment, although he had previously used multiple topical corticosteroids. Examination revealed eczematous patches and plaques involving 60% body surface area (BSA) and Investigator Global Assessment (IGA) 3, prompting initiation of dupilumab at standard dosing (600 mg loading dose followed by 300 mg every two weeks). Seven months after initiation, he developed pruritus and tearing of both eyes without pain or visual changes. Examination revealed few eczematous papules and plaques involving the scalp, trunk and extremities, BSA 3% and IGA 1, overall, much improved from prior examinations. Ophthalmologic exam showed bilateral upper and lower lid
