Dupilumab for the Treatment of Actinic Prurigo

A 42-year-old Latino man with a medical history of vitiligo presented to our outpatient clinic with a 25-year history of a recurrent, itchy eruption on his face and hands. Physical examination revealed pink, scaly, erythematous, lichenified papules and plaques with overlying crusts, photodistributed on the nose, chin, cheeks, hands, and ears (Figures 1a and 2a). The lips were edematous with hemorrhagic crusting, and conjunctival injection and partial corneal opacities were noted (Figures 1b-1c). Histologic evaluation demonstrated psoriasiform hyperplasia with hyper-granulosis and a superficial perivascular infiltrate composed of lymphocytes, histiocytes, and eosinophils. Human leukocyte antigen (HLA) class II typing was positive for HLA-DRB1*0407, thus confirming the diagnosis of actinic prurigo (AP).