Successful Treatment of Refractory Lichen Amyloidosus With Dupilumab

ABSTRACT Lichen amyloidosis (LA) is a chronic, pruritic dermatosis with papillary dermal amyloid deposition. Standard therapies often fail, and most reports of dupilumab in LA involve patients with concomitant atopic dermatitis. We report a 32‐year‐old man with refractory, non‐atopic LA who had failed topical corticosteroids, tacrolimus, phototherapy, and acitretin. After 6 months of dupilumab, near‐complete resolution of pruritus and major improvement of skin lesions were achieved. Repeat biopsy demonstrated marked reduction of CD4+ and CD8 + T‐cell infiltrates and complete amyloid clearance, with residual postinflammatory hyperpigmentation. These findings support a direct therapeutic effect of dupilumab in non‐atopic LA and a central role for type 2 inflammation in disease pathogenesis.