impact of the disease including the psychosocial burden, subsequent
post-inflammatory hyperpigmentation and in some cases
overall skin hyperpigmentation. Patients with atopic dermatitis
experience higher rates of anxiety, depression, sleep disorders,
and decreased work productivity.5 Additionally, the resulting
post-inflammatory hyperpigmentation can negatively impact
quality of life. The burden of atopic dermatitis in patients with
skin of color goes way beyond pruritus. In our case, aggressive
treatment with dupilumab resulted in improvement of the apparent
hyperpigmentation in clinically non-lesional skin (but
likely scientifically lesional skin), post-inflammatory hyperpigmentation
and atopic dermatitis.
DISCLOSURES
There are no potential perceived conflicts of interest and/or support, financial interests, or patents for Ciara Grayson.
Dr. Heath is a consultant for Sanofi-Regeneron and Pfizer.
Dr. Heath is a consultant for Sanofi-Regeneron and Pfizer.
REFERENCES
1. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387:1109–1122.
2. Weidinger S, Beck LA, Bieber T, et al. Atopic dermatitis. Nat Rev Dis Primers. 2018;4:1.
3. Fu T, Keiser E, Linos E, et al. Eczema and sensitization to common allergens in the United States: a multiethnic, population-based study. Pediatr Dermatol. 2014;31:21–26.
4. Kim Y, Blomberg M, Rifas-Shiman SL, et al. Racial/ethnic differences in incidence and persistence of childhood atopic dermatitis. J Invest Dermatol. 2019;139:827e34.
5. Eckert L, Gupta S, Amand C, et al. Impact of atopic dermatitis on healthrelated quality of life and productivity in adults in the United States: An analysis using the National Health and Wellness Survey. J Am Acad Dermatol. 2017;77(2):274–79.e3.
6. Suárez-Fariñas M, Tintle S, Shemer A, et al. Non-lesional atopic dermatitis (AD) skin is characterized by broad terminal differentiation defects and variable immune abnormalities. J Allergy Clin Immunol. 2011;127:954–64.e1–4. doi: 10.1016/j.jaci.2010.12.1124.
7. Alexis AF, Sergay AB, Taylor SC. Common dermatologic disorders in skin of color: a comparative practice survey. Cutis. 2007;80:387–94.
8. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3(7):20–31.
9. Papa CM, Kligman AM. The behavior of melanocytes in inflammation. J Invest Dermatol. 1965;45:465–473.
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-Yassky E, Bissonnette R, Ungar B, et al. Dupilumab progressively improves systemic and cutaneous abnormalities in patients with atopic dermatitis. J Allergy Clin Immunol. 2019;143:155–172.
12. Maymone MBC, Neamah HH, Wirya SA, et al. (2017). The 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.
2. Weidinger S, Beck LA, Bieber T, et al. Atopic dermatitis. Nat Rev Dis Primers. 2018;4:1.
3. Fu T, Keiser E, Linos E, et al. Eczema and sensitization to common allergens in the United States: a multiethnic, population-based study. Pediatr Dermatol. 2014;31:21–26.
4. Kim Y, Blomberg M, Rifas-Shiman SL, et al. Racial/ethnic differences in incidence and persistence of childhood atopic dermatitis. J Invest Dermatol. 2019;139:827e34.
5. Eckert L, Gupta S, Amand C, et al. Impact of atopic dermatitis on healthrelated quality of life and productivity in adults in the United States: An analysis using the National Health and Wellness Survey. J Am Acad Dermatol. 2017;77(2):274–79.e3.
6. Suárez-Fariñas M, Tintle S, Shemer A, et al. Non-lesional atopic dermatitis (AD) skin is characterized by broad terminal differentiation defects and variable immune abnormalities. J Allergy Clin Immunol. 2011;127:954–64.e1–4. doi: 10.1016/j.jaci.2010.12.1124.
7. Alexis AF, Sergay AB, Taylor SC. Common dermatologic disorders in skin of color: a comparative practice survey. Cutis. 2007;80:387–94.
8. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3(7):20–31.
9. Papa CM, Kligman AM. The behavior of melanocytes in inflammation. J Invest Dermatol. 1965;45:465–473.
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-Yassky E, Bissonnette R, Ungar B, et al. Dupilumab progressively improves systemic and cutaneous abnormalities in patients with atopic dermatitis. J Allergy Clin Immunol. 2019;143:155–172.
12. Maymone MBC, Neamah HH, Wirya SA, et al. (2017). The 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.
AUTHOR CORRESPONDENCE
Ciara Grayson MS ciaragrayson5@gmail.com
