Case Nº 050 · Dr. Danya Traboulsi

EC2Change Case FileAtopic dermatitis

A 23-year-old female with severe disease

Skin of colour
Special sites: hands, head

At a glanceCase Nº 050

At a glance

A 23-year-old female, severe atopic dermatitis

Score	Baseline	Latest visit
EASI	33	—
IGA	4	1

In this file

The patientCase Nº 050

The patient

year-old female,
severe disease

Skin of colour
Special-site involvement

Special sites involved: Hands, Head

Race / ethnicity

Phillipina

Fitzpatrick skin type

Fitz type V skin

Previous diagnoses

Atopic dermatitis Asthma Diabetes

Comorbidities & context

Asthma; diabetes; obesity has elevated liver enzymes on upadacitinib

Treatment historyCase Nº 050

Treatment history

What came before

Treatment at presentation

Rinvoq 30mg po daily Dupixent 300mg po q4wks Protopic 0.1% oint

Previous topical therapy

betaderm 0.1% oint, desonide oint, elocom oint

Previous systemic therapy

methotrexate - no improvement after > 3 mos; adtralza > 6 mos no improvement

Disease assessmentCase Nº 050

Disease assessment

Severity at baseline

EASI

Eczema Area and Severity Index

33of 72

IGA

Investigator's Global Assessment

4of 4

Disease assessmentCase Nº 050

Disease assessment

On the skin

Erythema

Red / pink

Site: periorbital

Treatment selectionCase Nº 050

Treatment selection

The plan

Initially treated w/ rinvoq and responded but after a year and a half lost efficacy so switched to adtralza. Despite six months on drug had no benefit. Added rinvoq back plus Adtralza again with no change. Is now on Dupixent + rinvoq with clear skin.

Treatment goals

Yes: no pruritus, able to sleep through the night and focus on school; normalize texture of skin periorbitally.

Treatment selectionCase Nº 050

Treatment selection

The plan, continued

Safety concerns

on rinvoq has elevated liver enzymes adtralza unfortunately didn't work and as a result had to be switched to alternative agent

Target scores

DLQI: 0

Follow-upCase Nº 050

Follow-up · visit 1 of 1

Under 6 months on treatment

3 months

IGA

Investigator's Global Assessment

1of 4

−3 vs baseline of 4

DLQI

Dermatology Life Quality Index

2of 30

Lesions at this visit

Erythema: — mild periorbital erythema

Symptoms & daily life

Pruritus: — resolved
Work impairment: — no issues
Impaired social function: — no issues

Follow-upCase Nº 050

Follow-up · visit 1 of 1

Visit 1, continued

Treatment plan

Treatment continued unchanged

Patient satisfied
Physician satisfied

OutcomesCase Nº 050

Outcomes

Scores over time

V = follow-up visit. Each scale starts at zero.

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

EC2Change Case File Nº 050

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