Effectiveness of Dupilumab for an Elderly Patient with Prurigo Nodularis Who Was Refractory and Contradicted to Traditional Therapy

Figures & data

Figure 1 Clinical presentation of an elderly patient with prurigo nodularis. Prurigo nodularis lesions involving the upper limbs and the trunk at baseline (W0). They were improved after dupilumab therapy at week 12 (W12).

Figure 2 Clinical scores of an elderly patient with prurigo nodularis during dupilumab therapy. (A) The changes of itch severity were measured by visual analogue scale. The changes of cutaneous lesions were assessed by (B) the counted number of nodules in dorsal side of the trunk and (C) IGA. (D) The quality of life was tested by DLQI.

Abbreviations: IGA, investigator’s global assessment; DLQI, Dermatology Life Quality Index.

Table 1 Review of Cases of Elderly Patients with Prurigo Nodularis Treated by Dupilumab

References	Age	Gender	History of Atopic Diseases	Blood Tests	Treatment Failures Before Dupilumab Therapy	Effected Evaluation of Dupilumab Therapy	Adverse Events
Beck et al^Citation7	70s	Male	NA	NA	Corticosteroids, hydroxyzine hydrochloride, doxepin, dronabinol, gabapentin, phototherapy, cryotherapy,	Pruritus and skin lesions improved with in 8 weeks	No
Giura et al^Citation8	85	Female	NA	Total IgE 168 KU/L, LDH 555 UI/L, eosinophil count 0.98×10^9/L	Topical and systemic corticosteroids	Pruritus and skin lesions approximately disappeared	No
Kovács et al^Citation9	80	Female	Atopic dermatitis	High total IgE	Topical corticosteroids, topical calcineurin inhibitors, antihistamines, antidepressants, gabapentin, cyclosporine, methotrexate, naloxone, UVB irradiation,	Pruritus improved with in 10 weeks	NA
Criado et al^Citation10	87	Male	Atopic dermatitis, rhinitis	Elevated eosinophil and IgE	Topical, intralesional, and systemic corticosteroids, mirtazapine, pregabalin, hydroxyzine, methotrexate, cyclosporine.	Pruritus improved with in 4 weeks. Pruritus and skin lesions approximately disappeared within 16 weeks	No
Wieser et al^Citation11	66	Female	No	NA	Topical corticosteroids, antihistamines, prednisone, methotrexate	Pruritus improved with in 20 weeks, skin lesions improved with in 16 weeks	No
Wieser et al^Citation11	65	Male	No	NA	Thalidomide, intralesional triamcinolone, gabapentin, phototherapy	Pruritus and skin lesions improved with in 4 weeks	No
Wieser et al^Citation11	65	Female	No	NA	Topical corticosteroids, tacrolimus 0.1% ointment, antihistamines, gabapentin, hydroxyzine	Pruritus and skin lesions improved with in 28 weeks	No

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