Severe atopic dermatitis treated with Dupilumab in a CTLA-4-deficient patient: A case report and review of the literature

Atopic dermatitis is a chronic inflammatory skin disease associated with immune dysregulation, particularly overexpression of T helper 2 cytokines. Cytotoxic T lymphocyte-associated antigen 4 deficiency, a primary immune disorder, can exacerbate atopic dermatitis. Dupilumab, an IL-4 and IL-13 receptor antagonist, has demonstrated efficacy in controlling severe, recalcitrant atopic dermatitis by mitigating T helper 2-driven inflammation. We present a case of a 24-year-old male with cytotoxic T lymphocyte-associated antigen 4 haploinsufficiency and severe atopic dermatitis successfully managed with Dupilumab. The patient showed marked improvement in eczema severity scores, including a sixfold reduction in the Eczema Area and Severity Index and a threefold reduction in the Dermatology Life Quality Index over 6 months, highlighting Dupilumab's potential role in cytotoxic T lymphocyte-associated antigen 4-deficient patients experiencing atopic dermatitis.