Perception and Experience of Dupilumab in Atopic Dermatitis: A Real-Life Study.

Purpose: There are few data on the practical use of dupilumab by the patients and on the patients' experience with this treatment. Objective: The objective of our study was to describe the experience and perception of dupilumab treatment in patients with atopic dermatitis (AD). Patients and Methods: We conducted a multicenter retrospective observational study including adult patients with moderate to severe AD treated with dupilumab between January 2017 and December 2021. Clinical characteristics were collected and a questionnaire was sent to all patients. It consisted of different parts including the injection method and different numeric rating scales (NRS) evaluating the patient's satisfaction and the constraints related to the treatment. Results: Eighty-two patients were included and the information was available for 77 patients who responded to the questionnaire. Injection of dupilumab was performed by a nurse in 47% (n=36) of patients and 43% (n=33) were autonomous. Injections were performed by a family member for 7 patients or by the general practitioner (1 patient). A wearing-off of the beneficial effect of dupilumab was reported by 47% of patients leading to shorten the dosing interval. In contrast, dose spacing was reported by 9 patients (11%). After a mean follow-up time of 29.7 ± 10.7 months (median: 27 months), drug survival was 72%. From the patients' perspective, the mean patient's satisfaction NRS score was 7.5 ± 1.8, and the constraints related to the treatment were scored at 3.1 ± 2.1 on NRS. Conclusion: Although AD treatments may contribute to the burden of the disease, dupilumab was associated with a lower burden score, likely reflecting both treatment efficacy and easy of use and patient satisfaction.

Dissecting cellulitis of the scalp treated by tumour necrosis factor inhibitors: a case series.

BACKGROUND: Dissecting cellulitis of the scalp (DCS), also known as Hoffmann disease or perifolliculitis capitis abscedens et suffodiens, is a rare disease characterized by chronic inflammation of the scalp. Treatment is difficult and often disappointing. OBJECTIVES: To report our experience of TNF inhibitors in a series of patients with DCS. MATERIALS & METHODS: We conducted a monocentric retrospective study of nine patients with DCS treated with TNF blocker after failure of other conventional treatments. RESULTS: After a mean duration of treatment by TNF inhibitors of 17 ± 16 months, four patients (44% versus 0%) had a Physician's Global Assessment score of 0 or 1. We observed a 67% reduction in the number of inflammatory nodules, an 88% reduction in purulent drainage and a 45% improvement in Dermatology Life Quality Index. The mean treatment satisfaction index was 6.6 ± 1.6 out of 10. CONCLUSION: Our study suggests that TNF inhibitors are effective against disease activity and may improve quality of life in the management of DCS refractory to conventional treatments.

Localized ecthyma gangrenosum without sepsis in a neutropenic patient with a myelodysplastic syndrome-Refractory anemia with excess blasts type 2.

The diagnosis of ecthyma gangrenosum should be evoked in front of maculopapular lesions rapidly evolving to necroting ulcers, particularly in the presence of prolonged neutropaenia or other hematological malignancies.