Efficacy of Dupilumab in a Young Woman with Refractory Cutaneous Lichen Planus: A Case-Based Review

TL;DR

A young woman with long-standing cutaneous lichen planus achieved full remission after two years of dupilumab treatment, suggesting its potential as a new therapy.

Contribution

This case study demonstrates the efficacy of dupilumab in treating refractory cutaneous lichen planus, highlighting Th2 pathway targeting as a novel therapeutic approach.

Findings

Dupilumab treatment led to full remission in a 26-year-old woman with longstanding cutaneous lichen planus.

The patient experienced resolution of severe pruritus and skin lesions after two years of dupilumab therapy.

The case suggests that targeting the Th2 pathway may be effective in treating refractory CLP.

Abstract

Background: Cutaneous lichen planus (CLP) is a chronic inflammatory T cell-mediated disease driven by a mixed Th1 and Th2 lymphocyte population, for which many of the currently available treatments have poor efficacy. Aim: The aim of this study was to indicate the clinical success of dupilumab administration after two years of treatment in a case of longstanding CLP and to perform a review of the medical literature related to the use of dupilumab in different dermatologic settings and in CLP. Case presentation: One 26-year-old woman with a previous history of atopic dermatitis had a long-lasting skin condition, referred to as a suspected lichen, which started when she was 7 years old. Her disease exhibited a relapsing–remitting course with severe bouts of pruritus over a very long period. The final histological diagnosis of CLP was confirmed at the age of 26. Starting dupilumab (injected subcutaneously at a dose of 600 mg followed by a maintenance dose of 300 mg every two weeks) resolved the skin scenery of this patient, who is currently in full remission. Conclusions: The remarkable recovery from CLP obtained via treatment with dupilumab in this single-patient case study emphasizes the potential therapeutic implications of targeting the Th2 pathway in this skin disorder.

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