Acral erythema arising in patients with atopic dermatitis after dupilumab therapy: A case report of 3 patients

Dupilumab, a monoclonal antibody approved by the U.S. Food and Drug Administration for the treatment of adult patients with moderate-to-severe atopic dermatitis, inhibits interleukins 4 and 13. It is an effective treatment option for atopic dermatitis, but facial redness has been reported as an unexpected adverse effect. Although several theories have been proposed to explain the facial redness caused by dupilumab, the underlying mechanism is yet to be verified. To the best of our knowledge, to date, only few reports have described erythema appearance on nonfacial areas after dupilumab treatment. Herein, we report the cases of 3 patients who presented with erythema on their hands and feet after dupilumab injections. The erythema persisted, even when the atopic dermatitis lesions improved. Additional reports are needed to demonstrate the clinical characteristics of postdupilumab acral erythema.