Efficacy of Dupilumab in Patients with Atopic Dermatitis and Alopecia Areata: A Case Series

Alopecia areata is a non-scarring immune-mediated alopecia, more common in patients affected by atopic dermatitis, in which a pathogenetic role of Th2 cells has been suggested.In Italy, at present, patients suffering from severe atopic dermatitis (Erythema Area and Severity Index, EASI, score ≥ 24), nonresponding or non-eligible to cyclosporine-A, are successfully treated with dupilumab, a monoclonal antibody blocking interleukin-4 and interleukin-13 signalling pathway.Herein we report the cases of four patients, three adults and one child, affected by both atopic dermatitis and alopecia areata, who were treated with dupilumab.Two adult patients achieved a complete, or almost complete, and sustained response in their alopecia areata when treated with dupilumab.The paediatric patient experienced a temporary improvement, while the fourth patient did not respond to treatment.Our findings are consistent with existing literature that suggests a dysregulation of the Th2 axis, which includes interleukin-4 and interleukin-13, playing a role in the development of alopecia areata.However, further research is needed to confirm the efficacy of dupilumab in treating alopecia areata.