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Case Nº 060 · Dr. Larry Cheung

EC2Change Case FileAtopic dermatitis

060

A 33-year-old female with moderate disease

  • Skin of colour
  • Special sites: hands, head, neck

Case byDr. Larry Cheung

1 follow-up visit

At a glanceCase Nº 060

At a glance

A 33-year-old female, moderate atopic dermatitis

ScoreBaselineLatest visit
EASI14—
IGA3—

In this file

1
The patientCase Nº 060

33

The patient

year-old female,
moderate disease

  • Skin of colour
  • Special-site involvement

Special sites involved: Hands, Head, Neck

Race / ethnicity

East Asian

Fitzpatrick skin type

III

Previous diagnoses

Eczema
2
Treatment historyCase Nº 060

Treatment history

What came before

Treatment at presentation

Abrocitinib and Betamethasone valerate

Previous topical therapy

Recorded, no detail given

Previous systemic therapy

Prednisone, Tralokinumab #Canada (2 months), Dupilumab #China (2 months), MTX 20 mg 1x/week, and Cyclosporin 100 mg BID
3
Disease assessmentCase Nº 060

Disease assessment

Severity at baseline

EASI

Eczema Area and Severity Index

14of 72

IGA

Investigator's Global Assessment

3of 4

4
Disease assessmentCase Nº 060

Disease assessment

On the skin

Erythema

  • Red / pink

Thickness

    Site: Face

    Lichenification

      Pigmentary changes

        5
        Disease assessmentCase Nº 060

        Disease assessment

        How it shaped care

        Impact on diagnosis

        Consider alternative dx

        Impact on treatment selection

        When patients do not respond to multiple systemic Rx
        Minimum trial period
        Physician goals
        Better ASAP
        Patient goals
        6
        Treatment selectionCase Nº 060

        Treatment selection

        The plan

        Abrocitinib 100 mg PO QD

        Treatment goals

        Patient wanted Dupilumab, then she wanted Abrocitinib

        What drove the choice

        Access

        Safety concerns

        Pregnancy
        7
        Follow-upCase Nº 060

        Follow-up · visit 1 of 1

        Under 6 months on treatment

        For each of the systemic Rx tried

        Lesions at this visit

        Erythema
        — Only responded to Abrocitinib
        Thickness
        — Only responded to Abrocitinib
        Lichenification
        — Only responded to Abrocitinib
        Pigmentary changes
        — To be continued...

        Treatment plan

        Treatment continued unchanged

        • Patient satisfied
        • Physician satisfied
        8

        A 33-year-old female with moderate atopic dermatitis.

        EC2Change Case File Nº 060

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