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Dupilumab for Atopic Dermatitis with Twenty-Nail Dystrophy: A Case Report.
Ji Li1, Duo Zhang1, Shuying Dong1
1Department of Dermatology, Affiliated Central Hospital of Shenyang Medical College, Shenyang, Liaoning, People's Republic of China.
Clinical, Cosmetic and Investigational Dermatology
|May 20, 2025
Summary
Atopic dermatitis (AD) can affect nails, causing twenty-nail dystrophy (TND). Dupilumab effectively treated a patient with AD and TND, improving both skin and nail symptoms.
Area of Science:
- Dermatology
- Immunology
Background:
- Atopic dermatitis (AD) commonly presents with skin issues, but nail changes like twenty-nail dystrophy (TND) are frequently missed.
- Nail involvement in AD may indicate a specific disease phenotype.
Observation:
- A 40-year-old woman presented with a 3-year history of itchy, eczematous skin around her nails and nail deformities.
- Dermatoscopy revealed thickened, yellowish nails with splinter hemorrhages, alongside elevated serum IgE levels.
Findings:
- The patient was diagnosed with AD and TND, and treated with dupilumab after conventional therapies failed.
- Within 2 weeks, dupilumab provided significant itch relief. By 5 months, nail recovery was nearly complete, and serum IgE levels decreased.
Implications:
- This case underscores the significance of identifying nail abnormalities in AD patients.
- Dupilumab demonstrates potential as an effective therapeutic option for AD-associated TND, meriting further investigation.
