Raffi Jodie, Suresh Raagini, Fishman Harvey, Botto Nina, Murase Jenny E
Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States.
Department of Dermatology, University of California, Irvine, Irvine, CA, United States.
Int J Womens Dermatol. 2019 Nov 7;5(5):308-313. doi: 10.1016/j.ijwd.2019.10.001. eCollection 2019 Dec.
The mechanisms underlying eye-related complications with dupilumab are poorly understood.
This study aimed to determine the incidence and characteristics of ocular complications with dupilumab and the prevalence of comorbid allergic contact dermatitis in the same subpopulation.
This is a retrospective chart review of 48 patients with atopic dermatitis who received dupilumab. For patients with eye involvement at first follow-up, we discuss the presence of eyelid dermatitis, blepharitis, or conjunctivitis and analyze available patch test findings in patients with ocular complications while treated with dupilumab.
A total of 14 patients (29.2%) showed eye involvement while on dupilumab, all of whom experienced eye involvement prior to dupilumab. The results of the patch test were most commonly positive for emulsifier/surfactants (42.5%) and fragrances (30.4%). Nine patients experienced improvement with allergen avoidance subsequent to patch testing, and four of nine patients' conditions cleared almost entirely. This is a non-randomized study in a small cohort of patients. Only 18 patients had their disease confirmed by an ophthalmologist.
All patients with eye involvement while on dupilumab had a history of eye involvement prior to dupilumab, suggest that dupilumab may encourage rather than cause ocular surface inflammation. Significant improvement after patch testing in nearly half of patients suggests that allergic contact dermatitis contributes to some cases of dupilumab-associated eye complications.
度普利尤单抗相关眼部并发症的潜在机制尚不清楚。
本研究旨在确定度普利尤单抗眼部并发症的发生率和特征，以及同一亚组中共患过敏性接触性皮炎的患病率。
这是一项对48例接受度普利尤单抗治疗的特应性皮炎患者的回顾性病历审查。对于首次随访时出现眼部受累的患者，我们讨论眼睑皮炎、睑缘炎或结膜炎的情况，并分析在接受度普利尤单抗治疗的眼部并发症患者中可用的斑贴试验结果。
共有14例患者（29.2%）在使用度普利尤单抗时出现眼部受累，所有患者在使用度普利尤单抗之前就已出现眼部受累。斑贴试验结果最常见的是乳化剂/表面活性剂阳性（42.5%）和香料阳性（30.4%）。9例患者在斑贴试验后通过避免接触变应原病情有所改善，其中9例患者中有4例病情几乎完全缓解。这是一项对一小群患者进行的非随机研究。只有18例患者的病情得到眼科医生的确诊。
所有在使用度普利尤单抗时出现眼部受累的患者在使用度普利尤单抗之前就有眼部受累史，这表明度普利尤单抗可能是促使而非导致眼表炎症。近一半患者在斑贴试验后有显著改善，这表明过敏性接触性皮炎在某些度普利尤单抗相关眼部并发症病例中起作用。
