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Case Nº 034 · Dr. Patrick Fleming

EC2Change Case FileAtopic dermatitis

034

A 22-year-old male with severe disease

  • Skin of colour
  • Special sites: head, neck

Case byDr. Patrick Fleming

1 follow-up visit

At a glanceCase Nº 034

At a glance

A 22-year-old male, severe atopic dermatitis

ScoreBaselineLatest visit
EASI242
BSA60%2%
IGA40

In this file

1
The patientCase Nº 034

22

The patient

year-old male,
severe disease

  • Skin of colour
  • Special-site involvement

Special sites involved: Head, Neck

Fitzpatrick skin type

IV

Comorbidities & context

None
2
Treatment historyCase Nº 034

Treatment history

What came before

Treatment at presentation

Adtralza

Previous topical therapy

Topical steroids, protopic, elidel, zoryve

Previous systemic therapy

Dupixent, Rinvoq
3
Disease assessmentCase Nº 034

Disease assessment

Severity at baseline

EASI

Eczema Area and Severity Index

24of 72

BSA

Body surface area

60%of 100%

IGA

Investigator's Global Assessment

4of 4

4
Disease assessmentCase Nº 034

Disease assessment

On the skin

Erythema

  • Red / pink
  • Site

Lichenification

    Pigmentary changes

    • Post-inflammatory hyperpigmentation
    5
    Treatment selectionCase Nº 034

    Treatment selection

    The plan

    Adtralza

    Treatment goals

    EASI of 2 (treat to target)

    What drove the choice

    Head and neck erythema with both Dupixent and Rinvoq

    Safety concerns

    None

    Target scores

    EASI
    1
    from 24
    BSA
    1%
    from 60%
    Itch NRS
    1
    IGA
    1
    from 4
    6
    Follow-upCase Nº 034

    Follow-up · visit 1 of 1

    Under 6 months on treatment

    EASI

    Eczema Area and Severity Index

    2of 72

    −22 vs baseline of 24

    BSA

    Body surface area

    2%of 100%

    −58 vs baseline of 60

    Itch NRS

    Peak pruritus numerical rating scale

    1of 10

    IGA

    Investigator's Global Assessment

    0of 4

    −4 vs baseline of 4

    Lesions at this visit

    Erythema
    — Less
    Pigmentary changes
    — Less
    7
    Follow-upCase Nº 034

    Follow-up · visit 1 of 1

    Visit 1, continued

    Symptoms & daily life

    Pruritus
    — Improved
    Work impairment
    — None
    Impaired social function
    — None

    Treatment plan

    Treatment continued unchanged

    • Patient satisfied
    8
    OutcomesCase Nº 034

    Outcomes

    Scores over time

    EASI030Target 1Baseline: EASI 2424V1: EASI 22BaselineV1BSA072Target 1%Baseline: BSA 60%60%V1: BSA 2%2%BaselineV1IGA04Target 1Baseline: IGA 44V1: IGA 00BaselineV1

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

    9

    A 22-year-old male with severe atopic dermatitis.

    EC2Change Case File Nº 034

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