Atopic Eczema — SCE Dermatology MCQ

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ModerateDermatopharmacologyAtopic EczemaSCE Dermatology

A 28-year-old woman with severe atopic eczema and conjunctivitis has been started on Dupilumab. She develops new-onset conjunctivitis 8 weeks into treatment. What is the most likely explanation?

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Correct answer: E — Dupilumab-associated conjunctivitis

Conjunctivitis is the most common adverse effect of Dupilumab, occurring in approximately 10-25% of patients in clinical trials. The mechanism is not fully understood but may relate to goblet cell loss and altered ocular surface immune homeostasis due to IL-13 blockade. Management is usually topical (artificial tears, fluorometholone eye drops); ophthalmology referral is recommended for persistent or severe cases. Dupilumab-associated conjunctivitis is generally not a reason to discontinue treatment unless severe. Tralokinumab (IL-13 only) has lower rates of conjunctivitis.

Reference: NICE TA534 2018; AAD 2023 AD Guidelines; BJD 2020