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Dupilumab-Associated Blepharoconjunctivitis with Giant Papillae
Filippos Vingopoulos1, Douglas R Lazzaro1
1New York University School of Medicine, Department of Ophthalmology, New York, NY 10017, USA.
International Medical Case Reports Journal
|August 18, 2020
Summary
Severe blepharoconjunctivitis associated with dupilumab treatment can be effectively managed with high-potency corticosteroid eyedrops. This case demonstrates successful treatment without altering dupilumab therapy for atopic dermatitis.
Area of Science:
- Ophthalmology
- Dermatology
- Pharmacology
Background:
- Dupilumab is a monoclonal antibody targeting the IL-4/IL-13 pathway, widely used for atopic dermatitis.
- Ocular surface disease is an emerging adverse effect associated with dupilumab therapy.
Observation:
- A 22-year-old female with severe atopic dermatitis developed severe blepharoconjunctivitis with giant papillae 20 weeks after initiating dupilumab.
- Symptoms included blurry vision, chalazia, eyelid swelling, and severe conjunctival injection.
Findings:
- The patient was treated with difluprednate 0.05% eyedrops twice daily for 7 days.
- Dupilumab therapy was continued without dose reduction due to significant improvement in atopic dermatitis.
- Ocular inflammation resolved within 2 months, with minimal need for maintenance corticosteroid eyedrops.
Implications:
- Ophthalmologists should be aware of potential ocular side effects of dupilumab.
- Prompt diagnosis and management with topical corticosteroids can effectively treat dupilumab-associated blepharoconjunctivitis.
- Continued dupilumab therapy is feasible in most cases of associated ocular surface disease.
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