Efficacy of dupilumab in a young woman with refractory cutaneous lichen planus: a case-based review

Background: Cutaneous lichen planus (CLP) is a chronic inflammatory T cell mediated disease driven by a mixed Th1 and Th2 lymphocyte population, for which we have poor efficacy data of many treatments available. Aim: To indicate the clinical success obtained through dupilumab administration after two years of treatment in a case of longstanding CLP and to perform a revision of the medical literature related to the use of dupilumab in different dermatologic sceneries and in CLP. Case presentation: One 26-year-old woman with previous history of atopic dermatitis had a longlasting skin picture referred to as a suspected lichen, started when she was 7-year-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 the dose of 600 mg, followed by a maintenance dose of 300 mg every two weeks) resolved the skin scenery of this patient, who is cur-rently on full remission. Conclusions: The remarkable recovery of CLP obtained via treatment with dupilumab in this single-patient case study emphasizes the potential therapeutic implications of targeting Th2 pathway in this skin disorder