Mochizuki Kosuke, Takeoka Jun, Toda Naohiro, Otsuka Kansei, Sato Ryo, Kurahashi Satoshi, Fujita Kyoka, Hirashima Hisako, Ishii Akira, Komiya Toshiyuki
Department of Nephrology, Kansai Electric Power Hospital, 2-1-7, Fukushima-Ku 54, Fukushima, Osaka, 553-0003, Japan.
Division of Renal Disease and Blood Purification, Kansai Electric Power Medical Research Institute, Osaka, Japan.
CEN Case Rep. 2025 Jun;14(3):450-454. doi: 10.1007/s13730-025-00980-9. Epub 2025 Mar 7.
Eosinophilia during the induction of peritoneal dialysis (PD) is frequently caused by icodextrin, but allergic reactions to PD catheters have been rarely reported. In previous reports, PD catheter-induced systemic contact dermatitis in patients undergoing PD sometimes required catheter removal, therefore there is a need to consider alternative renal replacement therapies other than PD. Here, we report a case of systemic contact dermatitis associated with a PD catheter that was successfully treated with dupilumab, avoiding catheter removal. The 62-year-old man undergoing PD had eosinophilia and pruritic skin rash after PD catheter implantation and was diagnosed with systemic contact dermatitis triggered by silicon contained in the catheter. Even though low doses of steroids were introduced, skin symptoms and eosinophilia were not controlled. After initiation of dupilumab treatment, skin pruritus was improved, and eosinophils also decreased. Although dupilumab use is expanding for systemic contact dermatitis, no previous reports of dupilumab administration in dialysis patients have been reported. This case is the first of a patient undergoing PD and using dupilumab for systemic contact dermatitis caused by a PD catheter, in which dupilumab successfully controlled skin rash and pruritus eosinophilia. Dupilumab is, therefore, a favorable option for treating systemic contact dermatitis induced by a PD catheter as an alternative to steroids and removal of the PD catheter.
腹膜透析（PD）诱导期的嗜酸性粒细胞增多症常由艾考糊精引起，但对PD导管的过敏反应鲜有报道。在既往报告中，PD患者发生的PD导管引起的全身性接触性皮炎有时需要拔除导管，因此有必要考虑除PD之外的其他肾脏替代治疗方法。在此，我们报告1例与PD导管相关的全身性接触性皮炎病例，该病例使用度普利尤单抗成功治疗，避免了导管拔除。这位接受PD治疗的62岁男性在植入PD导管后出现嗜酸性粒细胞增多症和瘙痒性皮疹，被诊断为由导管中含有的硅引发的全身性接触性皮炎。尽管使用了低剂量的类固醇，但皮肤症状和嗜酸性粒细胞增多症并未得到控制。开始度普利尤单抗治疗后，皮肤瘙痒得到改善，嗜酸性粒细胞也减少。尽管度普利尤单抗在全身性接触性皮炎中的应用正在扩大，但此前尚无在透析患者中使用度普利尤单抗的报告。该病例是首例接受PD治疗且使用度普利尤单抗治疗由PD导管引起的全身性接触性皮炎的患者，其中度普利尤单抗成功控制了皮疹、瘙痒和嗜酸性粒细胞增多症。因此，作为类固醇和拔除PD导管的替代方法，度普利尤单抗是治疗由PD导管引起的全身性接触性皮炎的一个有利选择。
