A linear lesion in a child with atopic dermatitis: Not a coincidence

Abstract

A blaschkolinear lesion in a patient with atopic dermatitis can be a superimposed segmental manifestation of this polygenic disorder. Knowledge of this phenomenon, presence of less severe, disseminated, symmetrically distributed lesions of the same disorder and, if necessary, histology are helpful in the differential diagnosis from other linear inflammatory diseases.

Superimposed linear atopic dermatitis treated with dupilumab

“…Seven cases of superimposed linear atopic dermatitis have been previously described. [1][2][3][4][5] Of the cases reported, the majority of patients had a history of atopic dermatitis during early childhood, [1][2][3][4] and while linear skin involvement tended to appear at a young age, onset ranged from 2-65 years. [1][2][3][4][5] All cases were characterized by severe, unilateral, linear arrangement involving the face, neck, arms, legs, abdomen, and/or trunk.…”

“…[1][2][3][4][5] Of the cases reported, the majority of patients had a history of atopic dermatitis during early childhood, [1][2][3][4] and while linear skin involvement tended to appear at a young age, onset ranged from 2-65 years. [1][2][3][4][5] All cases were characterized by severe, unilateral, linear arrangement involving the face, neck, arms, legs, abdomen, and/or trunk. [1][2][3][4][5] To our knowledge, this is the first reported case of superimposed linear atopic dermatitis, successfully treated with dupilumab.…”

“…These eruptions tend to be more severe and difficult to treat compared with generalized atopic dermatitis. Seven cases of superimposed linear atopic dermatitis have been previously described 1‐5 . Of the cases reported, the majority of patients had a history of atopic dermatitis during early childhood, 1‐4 and while linear skin involvement tended to appear at a young age, onset ranged from 2‐65 years 1‐5 .…”

“…Our patient failed several topical therapies and immune‐modulating therapies, and his severe presentation and intense pruritus necessitated more aggressive treatment. Prior cases of superimposed atopic dermatitis have been successfully treated with topical treatments, such as corticosteroids and fusidic acid, as well as systemic therapies, such as systemic antibiotics 1‐4 . While information is limited on long‐term treatment response, two patients treated with topical corticosteroids suffered from recurrence after cessation of therapy 3,4 …”

“…We present the case of a pediatric patient with severe superimposed linear atopic dermatitis and highlight the success of dupilumab in its treatment. While there are just several cases of superimposed atopic dermatitis with linear or segmental distributions published in the literature, it is important that clinicians recognize this condition as it is likely more common than reported 1,4 …”