Introduction

Recent groundbreaking research conducted by Abraham et al. has unveiled the remarkable effectiveness of dupilumab for patients grappling with hand and facial eczema, particularly those suffering from moderate to severe atopic dermatitis (AD). This study, presented at the prestigious 2025 American Academy of Dermatology Annual Meeting, utilized data from the TREATgermany multicenter registry, which is focused on long-term patient follow-up.

Study Overview

As of December 2023, the registry had enrolled 2,012 participants from 67 centers across Germany, all meeting the study's strict inclusion criteria, which required patients to exhibit moderate to severe AD as per the UK Working Party diagnostic criteria and to have a significant oSCORAD score exceeding 20, despite adhering to guideline-recommended topical therapies and/or receiving systemic anti-inflammatory treatments in the 24 months before participating.

Patient Demographics

Among the 455 patients in the primary subgroup (SG 1), who had a simultaneous diagnosis of moderate to severe AD (Investigator Global Assessment [IGA] scores ranging from 3 to 5), alarming symptoms affected various regions of the body: the face (72.4%), neck (75.6%), and inner arms (78.1%). Additional areas such as the backs of the knees, necks, and hands were also reported as severely impacted. Compounding their condition, patients reported an average Dermatology Life Quality Index (DLQI) score of 13.9, with serious impairments in sleep and pruritus, averaging scores of 5.6 and 6.9 respectively.

Treatment Outcomes

Of the patients in SG 1, 270 received treatment with dupilumab, yielding impressive results. By the time of the 3-month follow-up visit, facial eczema affliction dropped to 60.8%, inner arm symptoms decreased to 46.9%, while hand involvement fell to 26.9%. The improvements continued through the 6-month mark, highlighting a further decline in facial involvement to 53.8%, inner arms to 42.3%, and hands to 25.0%.

Quality of Life Improvements

Quality of life improvements were substantial, with the average DLQI score plunging from 13.9 to an impressive 5.5 after three months. Furthermore, IGA scores for hand eczema improved from 3.3 to 2.1, and from 3.3 to 2.3 for facial eczema. Notably, approximately 9.7% of participants experienced a local IGA score drop to either 0 or 1 for hand eczema, while 14% achieved similar outcomes for their facial condition at the 3-month follow-up.

Subgroup Results

In a smaller subgroup (SG 2), consisting of 12 patients with severe hand eczema (IGA scores of 3-5) and lower overall IGA scores (0-2), initial results were also promising. After three months of dupilumab, 16.7% noted significant improvements in their hand condition.

Conclusion

This study clearly demonstrates that treatment with dupilumab does not merely alleviate physical symptoms; it dramatically transforms patients' quality of life. As concluded by the researchers, "Treatment with dupilumab in AD patients resulted in marked improvements in both hand and facial eczema, as well as enhanced quality of life."

Upcoming Conference

For those looking to deepen their understanding of eczema treatment and breakthroughs, a chance to learn from leading experts awaits at the upcoming "Revolutionizing Atopic Dermatitis" conference in Nashville, Tennessee, on June 6-7. Don’t miss this opportunity to equip yourself with the latest knowledge in dermatologist care!