Site-Specific Response and Psychosocial Outcomes in Head and Neck Atopic Dermatitis Treated with Tralokinumab: A Prospective Real-World Study

BACKGROUND: Head and neck (H&N) involvement is a common and burdensome phenotype of atopic dermatitis (AD). Evidence integrating H&N-specific clinical response with longitudinal patient-reported outcomes remains limited. OBJECTIVE: To evaluate the effectiveness of tralokinumab in patients with H&N AD and assess its impact on quality of life and psychological outcomes. METHODS: In this prospective real-world study, 100 adults with moderate-to-severe AD received tralokinumab and were followed for up to 52 weeks. H&N involvement was assessed using the H&N EASI score. Clinical outcomes included H&N EASI reduction and achievement of H&N EASI75 at weeks 16, 32, and 52. Patient-reported outcomes included Dermatology Life Quality Index (DLQI), pruritus NRS, WHOQOL-BREF, PHQ-9, and BSI-18. RESULTS: Overall EASI decreased from 23.3 at baseline to 3.5 at week 52, and EASI75 was achieved by 68.3% and 88.0% of evaluable patients at weeks 16 and 52, respectively. Mean pruritus NRS decreased from 8.2 to 2.8, while mean DLQI decreased from 12.7 to 5.4. Among patients with baseline H&N involvement, H&N EASI decreased from 2.8 to 0.5 by week 52, and H&N EASI75 was achieved by 51.3% at week 16 and by approximately 70% at weeks 32 and 52. Patients with baseline H&N involvement maintained higher DLQI scores at week 52. One-year drug survival was 80.3%, while broader psychological outcomes showed variable changes. CONCLUSIONS: H&N involvement was frequent and may be associated with residual quality-of-life burden despite substantial clinical improvement with tralokinumab.