Atopic Eczema — SCE Dermatology MCQ

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EasyInflammatory DermatosesAtopic EczemaSCE Dermatology

A 35-year-old woman with moderate-to-severe atopic eczema has failed adequate trials of potent topical corticosteroids and topical calcineurin inhibitors. She has significant impact on quality of life (DLQI 18). She is considering systemic therapy. Which first-line biologic is most appropriate?

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Correct answer: B — Dupilumab

Dupilumab is a monoclonal antibody targeting IL-4 receptor alpha, blocking both IL-4 and IL-13 signalling. It is the first-line biologic recommended by NICE (TA534) for moderate-to-severe atopic eczema in adults who have failed topical therapy and at least one systemic immunosuppressant, or when these are contraindicated. Omalizumab targets IgE and is not recommended for atopic eczema. Secukinumab targets IL-17A (psoriasis). Mepolizumab targets IL-5 (eosinophilic asthma). Rituximab targets CD20 (not standard for eczema).

Reference: NICE 2018 TA534 Dupilumab for treating moderate to severe atopic dermatitis