First case report of vitiligo induced by dupilumab treatment

In a recent case report,1 Researchers have identified what appears to be the first reported case of vitiligo induced de novo by dupilumab therapy in patients with atopic dermatitis.

A 79-year-old patient, male, presented to investigators with vitiligo lesions that developed after dupilumab treatment for his persistent atopic dermatitis. During his 20 years with this condition, he has been treated with several other therapies, including systemic therapy (including cyclosporine and methotrexate), topical corticosteroids, and narrow-band (nb)-UVB phototherapy. These treatments showed signs of temporary or limited disease improvement.

During the first visit with the investigator, the patient had eczematous lesions affecting the backs of the hands as well as the neck and scalp.

  • Dermatology Quality of Life Index (DLQI) score of 20
  • Eczema Area and Severity Index (EASI) score 25
  • Pruritus Numerical Rating Scale (P-NRS) score 9

Based on these scores, the researchers began treating patients with an initial dose of 600 mg of dupilumab, followed by 300 mg of the drug every two weeks. After 4 weeks of treatment, the researchers determined that the patient was in complete remission of atopic dermatitis and established the following scores:

  • DLQI score of 0
  • EASI score of 0
  • P-NRS score 0

However, the researchers noted that the patient had hypopigmented patches affecting areas that once had eczema lesions.They performed a Woodlamp examination and skin biopsy.

They found the absence of melanocytes in the basal layer of the epidermis, some achromatosis as well as a skin inflammatory infiltrate of lymphocytes. The latter has a pronounced perivascular distribution.

Upon diagnosing the patient with vitiligo, the researchers continued to treat the patient with dupilumab in addition to initiating treatment with topical corticosteroids and nb-UVB phototherapy. I discovered that I experienced complete remission of my atopic dermatitis.

  • DLQI score of 0
  • EASI score of 0
  • P-NRS score 0

The researchers note that this is now the first report of such a case in the vitiligo literature, but they cite one existing publication.2 Researchers reported a patient with atopic dermatitis who presented with enlarged, colorless patches of vitiligo after starting treatment with dupilumab.

“Our case now appears to be the first report in the literature of de novo vitiligo induced by dupilumab therapy. The molecular drivers of vitiligo occurring during dupilumab treatment are unknown. 2 pathway and the Th1/Th17 pathway,” wrote the authors of the case report. “However, new research on this topic is needed to better understand the pathophysiological mechanisms underlying this rare adverse event. [adverse event] On dupilumab treatment.


  1. Picone V, Napolitano M, Torta G, Fabrocini G, Patruno C, vitiligo on dupilumab therapy: a case report. JAAD Case Report (2023)Doi:
  2. Takeoka S, Kamata M, Yokoi I, Takehara A, Tada Y. Rapid expansion of vitiligo vulgaris after initiation of journal pre-certification of dupilumab for atopic dermatitis: a case report. Acta Derm VenereolOct 2021 11028;101(10):adv00581.

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