[Peripheral ulcerative keratitis associated with dupilumab: a case report]

Area of Science:

• Ophthalmology
• Dermatology
• Pharmacology

Background:

• Dupilumab is a monoclonal antibody targeting the IL-4 receptor, used for treating moderate-to-severe atopic dermatitis.
• Ocular surface disease is a known potential side effect of dupilumab therapy.
• This case highlights a specific presentation of ocular inflammation potentially linked to dupilumab use.

Observation:

• A 68-year-old male on dupilumab developed foreign body sensation, photophobia, and tearing.
• Ophthalmic examination revealed a peripheral corneal ulcer in the right eye and limbal pannus in the left eye.
• Infectious etiologies were ruled out via corneal scraping and cultures.

Findings:

• The patient was treated with fluorometholone eye drops and recombinant bovine basic fibroblast growth factor eye drops.
• Corneal lesions showed significant improvement during the follow-up period.
• Corrected visual acuity in the right eye improved from 0.5 to 1.0 within 82 days.

Implications:

• This case suggests a possible association between dupilumab and the development of corneal ulcers.
• Early diagnosis and appropriate management, including anti-inflammatory and regenerative therapies, are crucial for favorable outcomes.
• Further research is warranted to elucidate the exact mechanism and incidence of such ocular side effects with dupilumab.