Allergic contact dermatitis (ACD) has been traditionally identified as TH1-mediated delayed-type hypersensitivity reactions. There is currently no Food and Drug Administration–approved systemic therapy indicated for ACD. Among patients with ACD, there is a subgroup that experience not only concomitant atopic dermatitis and ACD but also systemic allergic dermatitis driven by allergens encountered through dietary consumption. Basic science and clinical studies have supported the notion that ACD involves a complex interaction between both TH1 and TH2 axes of the secondary immune system on an allergen-by-allergen basis. Herein, we report the patients with systemic allergy syndrome with dermatitis to either Balsam of Peru or nickel who achieved remarkable improvement and regained their quality of life without continuing adherence to strict diets. Our study suggests that dupilumab may be an efficacious solution for a particular subgroup of patients with recalcitrant ACD when first- and second-line therapies have failed.
From the *Department of Dermatology, Loma Linda University, CA;
†School of Medicine, University of California, Riverside; and
‡Ronald O. Perelman Department of Dermatology, New York University, New York City.
Address reprint requests to Sharon E. Jacob, MD, Department of Dermatology, Loma Linda University, 11370 Anderson St, Ste 2600, Loma Linda, CA 92354. E-mail: email@example.com.
The authors have no funding or conflicts of interest to declare.