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Case Nº 059 · Dr. Daniel Wong

EC2Change Case FileAtopic dermatitis

059

A 60-year-old male with moderate disease

  • Skin of colour
  • Special sites: hands

Case byDr. Daniel Wong

1 follow-up visit
6 photographs

At a glanceCase Nº 059

At a glance

A 60-year-old male, moderate atopic dermatitis

ScoreBaselineLatest visit
IGA20
DLQI240

In this file

1
The patientCase Nº 059

60

The patient

year-old male,
moderate disease

  • Skin of colour
  • Special-site involvement

Special sites involved: Hands

Fitzpatrick skin type

5

Previous diagnoses

Chronic Hand Dermatitis (originally diagnosed as psoriasis)

Comorbidities & context

nil
2
Treatment historyCase Nº 059

Treatment history

What came before

Treatment at presentation

Alitretinoin Phototherapy (own home unit) Topical steroids

Previous topical therapy

topical steroids

Previous systemic therapy

alitretinoin

Previous other therapy

phototherapy home unit
3
Disease assessmentCase Nº 059

Disease assessment

Severity at baseline

IGA

Investigator's Global Assessment

2of 4

DLQI

Dermatology Life Quality Index

24of 30

4
Disease assessmentCase Nº 059

Disease assessment

On the skin

Lichenification

    Other: fissuring

    Beyond the skin

    • Pruritus
    • Work impairment
    5
    Disease assessmentCase Nº 059

    Disease assessment

    How it shaped care

    Impact on diagnosis

    Chronic Hand Dermatitis

    Impact on severity rating

    Low IgA score but high DLQI,

    Impact on treatment selection

    Pt wanted systemic option

    Impact on treatment priorities

    Disease control

    Impact on outcome measure

    Improvement of IGA and DLQI
    6
    Disease assessmentCase Nº 059

    Disease assessment

    How it shaped care, continued

    Improvement of IGA and DLQI
    Physician goals
    Decreased pain, easier to do his job
    Patient goals
    7
    Disease assessmentCase Nº 059

    Baseline photographs

    8
    Disease assessmentCase Nº 059

    Baseline photographs

    9
    Treatment selectionCase Nº 059

    Treatment selection

    The plan

    Tralokinumab

    Treatment goals

    decreased fissuring and pain to hands

    What drove the choice

    Pt wished to pursue a systemic, was frustrated with lack of improvement so far Was seen for a few years by another dermatologist, looking for alternative options to what he's used before pt was very motivated

    Safety concerns

    No safety concerns
    10
    Treatment selectionCase Nº 059

    Treatment selection

    The plan, continued

    Target scores

    IGA
    0
    from 2
    DLQI
    0
    from 24
    11
    Follow-upCase Nº 059

    Follow-up · visit 1 of 1

    Under 6 months on treatment

    3 months

    IGA

    Investigator's Global Assessment

    0of 4

    −2 vs baseline of 2

    DLQI

    Dermatology Life Quality Index

    0of 30

    −24 vs baseline of 24

    Lesions at this visit

    Lichenification
    — improved
    Other
    — improved
    12
    Follow-upCase Nº 059

    Follow-up · visit 1 of 1

    Visit 1, continued

    Treatment plan

    Treatment continued unchanged

    • Patient satisfied
    • Physician satisfied
    13
    Follow-upCase Nº 059

    Visit 1 photographs

    14
    Follow-upCase Nº 059

    Visit 1 photographs

    15
    OutcomesCase Nº 059

    Outcomes

    Scores over time

    IGA04Target 0Baseline: IGA 22V1: IGA 00BaselineV1DLQI030Target 0Baseline: DLQI 2424V1: DLQI 00BaselineV1

    V = follow-up visit. Each scale starts at zero. Grey line = physician’s target.

    16

    A 60-year-old male with moderate atopic dermatitis.

    EC2Change Case File Nº 059

    Contributed by Dr. Daniel Wong. Compiled from the physician’s case-builder submission, in their own words.