Lack of efficacy of dupilumab in the treatment of keloid disorder

Abstract

Lack of efficacy of dupilumab in the treatment of keloid disorderDear Editor, Keloid disorder (KD), a group of fibroproliferative skin diseases, with keloids serving as the prototype, has a high degree of morbidity with major impact on the quality of life of the affected individuals. 1,2 With the highly variable and diverse presentations, there is a need for different treatment options to address the unique clinical scenarios in each patient. Although localized treatments may be appropriate for patients with early and limited stages of KD, patients with more advanced disease would benefit from systemic therapy. 3 In 2020, Diaz et al. 4 reported a 53-year-old African American male with atopic dermatitis treated with dupilumab. This patient also had two exophytic nodules in his right popliteal fossa that were diagnosed as keloids. In addition to improvement in atopic dermatitis, reduction in the size of both lesions was reported during treatment with dupilumab, suggesting a therapeutic potential for dupilumab and possibly other Th2-targeting drugs for the treatment of keloids. Based on this report, we referred a total of 16 KD patients for offlabel treatment with dupilumab either to their own primary dermatologists or to Diaz's group. 4 In addition, we recently encountered another keloid patient (patient #17) who was being treated with dupilumab for nasal polyps for 10 months. This patient is also included in our efficacy analysis (Table 1).

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

“…Dupilumab was evaluated in a total of 12 reported cases with keloids ( Table 8 ). One case showed size reduction of the keloid [ 248 ], one case with a highly pruritic keloid reported reduction of itch [ 249 ]; however, the remaining 10 cases did not report any effects of dupilumab or deterioration [ 250 , 251 ]. Two clinical trials evaluating dupilumab in keloids are currently recruiting (NCT04988022, NCT05128383).…”