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A 34¢YEAR¢OLD MAN WITH A HISTORY OF CHRONIC ATOPIC DERMATITIS WAS STARTED ON A BIOLOGIC AGENT TO TREAT HIS ATOPIC ECZEMA. ONE MONTH AFTER the initiation of t he biolog ic a gent , he ret ur ned for a routine follow-up visit with this clinical presentation. He said his eyes were "sore and very itchy." He said the eye concern started about two or three weeks after the first injection of the biologic agent. Diag nosis: Dupilumab (Dupixent) -associated conjunctivitis The U.S. Food and Drug Administration a p p r o v e d D u p i x e n t (d u p i l u m a b) injection to treat adults with moderate- t o -severe eczem a (atopic dermatitis) on March 28, 2017. For t unately, for d e r m a t o l o g i s t s t r e a t i n g a t o p i c / chronic eczema and patients who have atopic/chronic der- matitis, Dupixent, has been a rea l game changer. Unfortunately, 5 to 10 percent of patients receiving Dupixent develop si g n i f ic a nt c onju nc t iv it i s , u s u a l ly t wo t o fou r we ek s a f t er b e g i n n i n g the medication. The injections are done twice monthly, w it h a double loading dose (600mg) done the very first treatment and then a single dose (300mg) twice monthly after that. Dupixent is FDA approved for patients 18 years and older. Studies are currently underway to eva luate safety a nd ef fectiveness i n patient s u nder age 18. For patients who develop conjunctivi- tis while on Dupixent, the first approach is to use a moisturizing eye drop ( like Systane eye drops available over-the- counter), four times da i ly for f ive to seven days. If that does not control the condition, they should be referred to an ophtha lmologist for additiona l eva lu- ation/treatment or discontinuation of the medication. In the majority of cases where the conjunctivitis is unmanage- able or incompatible with staying on Dupi xent, conjunctivitis will resolve within a month of discontinuation of Dupixent. In a small percentage of cases, conjunctivitis can be long-lasting, even after discontinuation of the biologic and will require long-term ophtha lmolo- gist care. F o r m o r e i n f o r m a t i o n , c o n t a c t C h arl es E . C r utchf i el d I I I , M D , at C r u t c h f i e l d D e r m a t o l o g y o r v i s i t CrutchfieldDermatology.com. ■ Case of the Month with Crutchfield Dermatology D I A G N O S T I C S 2 3 Make a referral today. stdavidscenter.org/referral East African Autism Day Treatment 2 3 M D N E W S . C O M /// M D N E W S M I N N E S O TA ■ 2 018