Dupilumab
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Corneal ulceration: case report A 50-year-old man developed corneal ulceration during treatment with dupilumab for atopic dermatitis. The man presented due to irritation, constant foreign body sensation and redness in the right eye. He received treatment with naphazoline; however, only irritation resolved. Three weeks prior to the presentation, he had received IV dupilumab at a dose of 1200mg initial dose and subsequent 300mg doses every 2 weeks. At presentation, his best corrected visual acuity was 20/125 OS and 20/40 OD. Slit lamp examination exhibited floppy eyelids and mild exposure that were symmetrical in both eyes. The right eye was notable for an inferior, paralimbal dense corneal infiltrate with a full epithelial defect and 30% corneal thinning. A diagnosis of corneal ulcer was made. The man’s treatment with dupilumab was discontinued. He was started on moxifloxacin. After two days, his symptoms stabilised. Despite antibiotic treatment, his corneal ulcer persisted. Therefore, moxifloxacin dose was reduced. Prednisolone was added to his treatment. After four days, resolution of his ocular symptoms of eye pain, itching, or discomfort was noted. A marked improvement in conjunctival injection, closure of the epithelial defect and resolution of the corneal infiltrate was observed upon slit lamp examination. His treatment was switched to cyclosporine and tacrolimus. Prednisolone was tapered off. After one month of the presentation, his corneal ulcer resolved. Li G, et al. Corneal ulceration associated with dupilumab use in a patient with atopic dermatitis. American Journal of Ophthalmology Case Reports 19: Sep 2020. Available 803499339 from: URL: http://doi.org/10.1016/j.ajoc.2020.100848
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Reactions 5 Sep 2020 No. 1820
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