Development of Café-Au-Lait-Macule Lesions in a Patient After Dupilumab Therapy for Atopic Dermatitis

Atopic dermatitis (AD) is a chronic immune-mediated disease characterized by intense pruritis, causing inflammation, itching, and redness of the skin. Dupilumab is a human monoclonal antibody that has been approved for the treatment of atopic dermatitis. It has also been linked with various adverse effects, most of them confined to the injection site. Café-au-lait-macules are benign pigmented lesions of the skin, usually seen in people with genetic disorders. We present a case of café-au-lait macules as an adverse effect of dupilumab therapy in a patient with atopic dermatitis. The patient in this case had been receiving dupilumab therapy for atopic dermatitis. The eczematous lesions had seen improvement; however, the patient presented with CALMs on follow-up, which seem to be linked with dupilumab therapy.