Dermoscopy is a Feasible Tool for Assessment of Inflammatory Skin Changes After Dupilumab Therapy

A novel study evaluated the use of dermoscopy and clinical evaluation in monitoring biologic treatment of atopic dermatitis.

In patients with atopic dermatitis, noninvasive dermoscopy is an effective strategy for monitoring changes in disease severity and outcomes following treatment with dupilumab, according to study research published in the Journal of the European Academy of Dermatology and Venereology.

A total of 22 adults with atopic dermatitis (median age, 38.8 years) were included in the observational study. Patients were treated with dupilumab for 16 weeks. The treatment doses included a 600 mg induction dose and a 300 mg dose administered every 2 weeks thereafter.

In each patient, an eczematous target lesion localized on the head, neck, or hands was selected and monitored at baseline and at 16 weeks after treatment. Erythema, erosions, and scales were the primary features evaluated in each lesion. Investigators assessed changes in the Eczema Area Severity Index (EASI), Pruritus-Numeric Rating Scale (P-NRS), and Dermatology Life Quality Index (DLQI) from baseline to 16 weeks after dupilumab therapy.

Examination by videodermoscopy was performed with 150X videodermatoscope. At baseline, videodermoscopy revealed several specific features in all targeted lesions. These features included light red backgrounds with patchy or irregularly dotted vessels and yellow crusts with less pronounced diffuse white scales.

Serocrusts, scales, and diffuse erythema improved after 16 weeks of dupilumab. The researchers also observed vascular network normalization after treatment. Reductions were observed in values of erythema (2.5±0.51 vs 0.4±0.5), scales (1.75±0.81 vs 0.04±0.21), and erosion (1.9± 0.71 vs 0.25±0.44) from baseline to 16 weeks (P <.05).

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There was a significant improvement in the mean EASI from baseline to after 16 weeks of treatment (49.72±12.34 vs 1.68±3.58, respectively; P <.001). In addition, the investigators observed significant improvements from baseline to 16 weeks in the mean P-NRS score (8.18±1.36 vs 0.5±1.37, respectively; P <.001) and the mean DLQI (21.68±6.04 vs 0.68±1.74, respectively; P <.001).

Based on this and other research findings, the study investigators concluded that dermoscopy in the assessment of inflammatory skin disorders may likely “enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology.”

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Ferrillo M, Patruno C, Villani A, et al. Dermoscopic assessment of long-term systemic therapy with dupilumab in adult atopic dermatitis [published online April 2, 2020]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.16409