Full scalp hair regrowth in a 4-year-old girl with alopecia areata and atopic dermatitis treated with dupilumab

Remission of Alopecia Universalis after 1 Year of Treatment with Dupilumab in a Patient with Severe Atopic Dermatitis

“…Considering that AA has been classified as T helper 1-driven disease, whereas AD is the prototypical T helper 2 (Th2)-driven skin disorder, recent studies suggest that these forms may underlie a different chemokine expression resulting in a Th2 skewing as a key pathomechanism that could explain this association [3]. Several reports showed that dupilumab, a fully human monoclonal antibody targeting the interleukin (IL)-4α and IL-13 receptors and thus downregulating Th2 response, led to an improvement of AA associated with AD: the first report by Penzi et al [4] observed a full hair regrowth in a 13-yearold girl affected by AT and severe AD after 11 months of treatment with dupilumab; subsequently, several authors described an improvement of AA in their patients treated with dupilumab [5][6][7][8][9][10]. Although cases of AA induced by dupilumab have been described [11][12][13], it is possible that sex difference, AD duration, and immunological profile of the patients play a crucial role in the treatment's response; in fact as outlined by Marks et al [14], most of the patients in which dupilumab improved AA were females with AT or AU, early-onset AD, and atopic comorbidities, suggesting a predominant role of Th2 skewing in this subset of patients.…”

Dietary Habits in Japanese Patients with Alopecia Areata

“… 4 Alopecia areata is frequently associated with atopic dermatitis (AD), a Th2-enhanced allergic disease. 4 Treatment of patients with AD using dupilumab, an anti-IL-4 receptor α antibody, was shown to improve concomitant AA, 5 indicating a supportive role for Th2 cytokines in the pathogenesis of AA.…”

Time to loss of response for dupilumab in ophiasis-pattern alopecia areata

“… 1 Although there is variation among responders, the recovery of hair in some cases is profound. 2 , 3 Our patient experienced a rapid response to treatment with dupilumab, showing visible hair growth 2 weeks after initiating therapy. Her hair recovery was faster than in other case reports of responders despite not following a standardized injection schedule.…”