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Case Nº 029 · Dr. Maninder Longowal

EC2Change Case FileAtopic dermatitis

029

A 23-year-old male with severe disease

  • Special sites: hands, head, neck

Case byDr. Maninder Longowal

1 follow-up visit
1 photograph

At a glanceCase Nº 029

At a glance

A 23-year-old male, severe atopic dermatitis

ScoreBaselineLatest visit
EASI203
BSA17%1%
IGA43
DLQI28—

In this file

1
The patientCase Nº 029

23

The patient

year-old male,
severe disease

  • Special-site involvement

Special sites involved: Hands, Head, Neck

Previous diagnoses

Atopic Dermatitis since childhood mild asthma chronic hand dermatitis
2
Treatment historyCase Nº 029

Treatment history

What came before

Treatment at presentation

Adtrazla, clobetasol

Previous topical therapy

lyderm , clobetasol, protopic, zoryve

Previous systemic therapy

mtx, prednisone
3
Disease assessmentCase Nº 029

Disease assessment

Severity at baseline

EASI

Eczema Area and Severity Index

20of 72

BSA

Body surface area

17%of 100%

IGA

Investigator's Global Assessment

4of 4

DLQI

Dermatology Life Quality Index

28of 30

4
Disease assessmentCase Nº 029

Disease assessment

On the skin

Erythema

  • Red / pink

Site: face, hands

Lichenification

  • Furrowing

Site: hands

Excoriation

  • Bleeding
5
Disease assessmentCase Nº 029

Disease assessment

How it shaped care

Impact on severity rating

hands were very fissured, affecting his ability to work and gain employment
more confidence in public settings
Patient goals
6
Disease assessmentCase Nº 029

Baseline photographs

7
Treatment selectionCase Nº 029

Treatment selection

The plan

adtralza, optional rescue TCS

Treatment goals

patient wanting improvement to facial and hand AD to help gain employment as engineer

What drove the choice

we had a study looking at adtrazla for hand dermatitis

Safety concerns

minimal, many options available
8
Treatment selectionCase Nº 029

Treatment selection

The plan, continued

Target scores

EASI
4
from 20
BSA
5%
from 17%
IGA
1
from 4
DLQI
5
from 28
9
Follow-upCase Nº 029

Follow-up · visit 1 of 1

Under 6 months on treatment

seen regularly due to clinical trial setting

EASI

Eczema Area and Severity Index

3of 72

−17 vs baseline of 20

BSA

Body surface area

1%of 100%

−16 vs baseline of 17

IGA

Investigator's Global Assessment

3of 4

−1 vs baseline of 4

Lesions at this visit

Erythema
— facial and neck erythema worsened
Lichenification
— eyelids
10
Follow-upCase Nº 029

Follow-up · visit 1 of 1

Visit 1, continued

Symptoms & daily life

Pruritus
— significant facial involvement
Work impairment
— still low confidence

Treatment plan

Treatment continued unchanged

  • Physician satisfied
11
OutcomesCase Nº 029

Outcomes

Scores over time

EASI020Target 4Baseline: EASI 2020V1: EASI 33BaselineV1BSA020Target 5%Baseline: BSA 17%17%V1: BSA 1%1%BaselineV1IGA04Target 1Baseline: IGA 44V1: IGA 33BaselineV1

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

12

A 23-year-old male with severe atopic dermatitis.

EC2Change Case File Nº 029

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