Successful Treatment of Recalcitrant Eosinophilic Pustular Folliculitis with Dupilumab

TL;DR

A 77-year-old woman with a severe, treatment-resistant skin condition was successfully treated with a new biologic drug called dupilumab.

Contribution

This case report demonstrates dupilumab's effectiveness in treating refractory eosinophilic pustular folliculitis.

Findings

Dupilumab significantly improved the patient's symptoms and quality of life.

The treatment was well-tolerated and effective for a condition with limited therapeutic options.

The case suggests dupilumab may be a promising therapy for refractory EPF.

Abstract

Eosinophilic pustular folliculitis (EPF) is a chronic inflammatory condition characterised by the appearance of excoriated papules involving the face, neck, trunk, and root of limbs. It is a rare disease, and most treatments rely on reports of isolated cases or small case series. Numerous treatments have been employed throughout history, with variable effectiveness, including indomethacin, corticosteroids, calcineurin inhibitors, dapsone, cyclosporine, tetracyclines, isotretinoin or narrowband ultraviolet B therapy. We report the successful treatment of a 77-year-old female patient who presented to a tertiary care hospital in Valencia, Spain, in 2024 with refractory EPF, which significantly affected her quality of life due to uncontrollable pruritus, with dupilumab. With the advent of new biologic drugs and small molecule therapies, it is hoped that diseases traditionally lacking effective treatments will have new valid and safe treatment options.

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