Nonresponse and Progression of Diffuse Keloids to Dupilumab Therapy

Th2 cytokines, including IL-4 and IL-13, have been shown to increase TGFβ, promoting fibrosis. A recent study showed keloid improvement in one patient after administration of Dupilumab, an IL-4 receptor alpha-antagonist, for his/her atopic dermatitis. Here, we present two 17-year-old patients with diffuse keloids without improvement after three months of Dupilumab treatment, with one patient experiencing clinical worsening. It is currently unknown if Th2 cytokine blockade in patients with keloids reduces TGFβ synthesis or activation. Future studies are needed to investigate the utility of Th2 cytokine blockade as a potential treatment option for keloids. J Drugs Dermatol. 2022;21(2):197-199. doi:10.36849/JDD.6252.