| Presentation preference | Poster presentation |
| Title | Peripheral Ulcerative Keratitis Secondary to Dupilumab Treatment |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To report two cases of peripheral ulcerative keratitis (PUK) secondary to dupilumab treatment for atopic dermatitis. |
| Methods | Dupilumab is effective in treating various immune-mediated conditions, including as atopic dermatitis, moderate to severe asthma, and allergic rhinitis. Its most common ocular adverse events include conjunctivitis, blepharitis and keratitis. We report a rare case of peripheral ulcerative keratitis, underscoring this potentially serious adverse event. |
| Results | Case 1: A 46-year-old woman with one-year history of severe atopic dermatitis developed persistent bilateral conjunctival injection and right eye ocular pain after six months of dupilumab treatment. Examination revealed a peripheral corneal ulcer with circumferential progression, despite the discontinuation of dupilumab and the use of topical prednisolone. Immunomodulatory treatment was started with methotrexate 25 mg/week subcutaneously. Due to persistent activity rituximab was added, resulting in complete healing of the ulcer after 3 months.
Case 2: A 27-year-old woman receiving dupilumab treatment for severe atopic dermatitis, with a history of herpetic eye disease under prophylactic acyclovir, reported a white spot on her right eye. Examination revealed conjunctival injection and a perilimbar infiltrate that had not responded to topical prednisolone, and showed circumferential progression. Dupilumab was discontinued, and oral prednisone 16 mg/day was initiated, leading to a favorable response.
|
| Conclusion | While most of ocular complications associated with dupilumab are mild to moderate, some may require careful management, medication adjustments, or even the discontinuation of dupilumab therapy, as seen in the cases of PUK.
|
| Conflict of interest | No |
1
| Last name | MONTOYA |
| Initials of first name(s) | J |
| Department | Uveitis section, ophthalmology department, José de San Martin clinic hospital |
| City | Buenos Aires |
| Country | Argentina |
2
| Last name | GARCÍA |
| Initials of first name(s) | M |
| Department | Uveitis section, ophthalmology department, Italian hospital of Buenos Aires |
| City | Buenos Aires |
| Country | Argentina |
3
| Last name | RODRÍGUEZ |
| Initials of first name(s) | S |
| Department | Uveitis section, ophthalmology department, Italian hospital of Buenos Aires |
| City | Buenos Aires |
| Country | Argentina |
4
| Last name | SOLER |
| Initials of first name(s) | T |
| Department | Uveitis section, ophthalmology department, Italian hospital of Buenos Aires |
| City | Buenos Aires |
| Country | Argentina |
5
| Last name | BURSZTYN |
| Initials of first name(s) | M |
| Department | Uveitis section, ophthalmology department, Italian hospital of Buenos Aires |
| City | Buenos Aires |
| Country | Argentina |
6
| Last name | SCHLAEN |
| Initials of first name(s) | A |
| Department | Uveitis section, ophthalmology department, Italian hospital of Buenos Aires |
| City | Buenos Aires |
| Country | Argentina |
