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Case Nº 014 · Dr. Marisa Ponzo

EC2Change Case FileAtopic dermatitis

014

A 49-year-old male with moderate disease

  • Special sites: hands

Case byDr. Marisa Ponzo

1 follow-up visit
3 photographs

At a glanceCase Nº 014

At a glance

A 49-year-old male, moderate atopic dermatitis

ScoreBaselineLatest visit
IGA30

In this file

1
The patientCase Nº 014

49

The patient

year-old male,
moderate disease

  • Special-site involvement

Special sites involved: Hands

Previous diagnoses

Chronic hand eczema

Comorbidities & context

Hypercholesterolemia
2
Treatment historyCase Nº 014

Treatment history

What came before

Treatment at presentation

Topical treatment

Previous topical therapy

Clobetasol cream, Bryhali lotion, Fucibet cream
3
Disease assessmentCase Nº 014

Disease assessment

Severity at baseline

IGA

Investigator's Global Assessment

3of 4

4
Disease assessmentCase Nº 014

Disease assessment

On the skin

Erythema

  • Red / pink

Thickness

    Site: palms, lateral fingers

    Other: Deep painful fissures

    Lichenification

    • Furrowing

    Excoriation

    • Bleeding
    5
    Disease assessmentCase Nº 014

    Disease assessment

    How it shaped care

    Impact on treatment selection

    Non compliance with topical treatment
    6
    Disease assessmentCase Nº 014

    Baseline photographs

    Fissured scaly plaques on palms
    Fissured scaly plaques on palms and lateral fingers
    7
    Treatment selectionCase Nº 014

    Treatment selection

    The plan

    Tralokinumab

    Treatment goals

    Clearance of chronic hand eczema - especially deep fissures and bleeding.

    What drove the choice

    Discussed systemic options due to ease of administration

    Safety concerns

    None
    8
    Treatment selectionCase Nº 014

    Treatment selection

    The plan, continued

    Target scores

    IGA
    0
    from 3
    9
    Follow-upCase Nº 014

    Follow-up · visit 1 of 1

    Under 6 months on treatment

    3mo

    IGA

    Investigator's Global Assessment

    0of 4

    −3 vs baseline of 3

    Lesions at this visit

    Erythema
    — clear
    Thickness
    — clear
    Lichenification
    — clear
    Excoriation
    — clear
    10
    Follow-upCase Nº 014

    Follow-up · visit 1 of 1

    Visit 1, continued

    Symptoms & daily life

    Work impairment
    — No longer bleeding at work
    Impaired social function
    — No longer bleeding at home, or in social settings

    Treatment plan

    Treatment modified

    Modification made
    — He will move to q4 week dosing now that he is clear and has no flares pre-dosing.
    11
    Follow-upCase Nº 014

    Visit 1 photographs

    12
    OutcomesCase Nº 014

    Outcomes

    Scores over time

    IGA04Target 0Baseline: IGA 33V1: IGA 00BaselineV1

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

    13

    A 49-year-old male with moderate atopic dermatitis.

    EC2Change Case File Nº 014

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