Dupilumab In Patients With Vernal Keratoconjunctivitis And Concomitant Atopic Dermatitis: A Case Series And Literature Review

To present our clinical experience with systemic Dupilumab in patients diagnosed with vernal keratoconjunctivitis (VKC) and concomitant atopic dermatitis (AD) and to review the literature on other potential immunobiologic therapies for VKC.

Hadassah Medical Center - Hebrew University Hospital.

A retrospective chart review was conducted on three pediatric patients who initiated Dupilumab therapy for AD following a diagnosis of VKC. Additionally, a literature review was performed to evaluate other emerging immunobiologic treatments for VKC.

Two males (8 and 10 years) presented with a shield ulcer in 1 eye and underwent keratectomy. One of them had CXL for progressive KC in the contralateral eye which was complicated by shield ulcer formation. The third patient (9 years) presented to the emergency with bilateral confluent PEEs. All patients had been treated with topical tacrolimus following VKC diagnosis, with frequent flare-ups needing topical steroids. All 3 patients were initiated on systemic Dupilumab for AD. The first 2 patients experienced significant improvement in both VKC and AD, while the 3^rd patient continued to require rescue steroid drops and skin creams. No Dupilumab-adverse events were observed. We reviewed the literature for other immunobiologic VKC therapies.

Despite potential ocular surface side effects such as conjunctivitis, systemic Dupilumab may serve as an effective adjunctive therapy for VKC in patients with concomitant AD, particularly in those with refractory disease. Emerging immunobiologic therapies hold promise for refractory VKC management, warranting further investigation into their efficacy and safety.