Hand eczema in a healthcare professional: use of dupilumab and impact on quality of life

Abstract

Objective: To present an case report of a physician with hand eczema (HE) refractory to conventional treatment, highlighting the diagnostic and therapeutic challenges faced, as well as the clinical evolution after the use of dupilumab and its impact on quality of life. Case details: A 29-year-old physician, with a history of atopic dermatitis and asthma, developed HE. Initially, the lesions were superficial and partially responsive to topical corticosteroids. Subsequently, the condition worsened, with fissures, pain, edema, and intense pruritus, compromising daily activities and professional practice, in addition to negatively affecting mental health and quality of life. Conventional treatment, including topical and oral corticosteroids, showed limited response. Dupilumab was then initiated, leading to significant lesion remission within four weeks and consistent improvement in SCORAD, ADCT, and DLQI scores after three and a half months. Final considerations: This case illustrates the diagnostic and therapeutic complexity of HE, especially in healthcare professionals exposed to occupational risk factors. Dupilumab demonstrated clinical efficacy and a positive impact on quality of life, reinforcing the importance of innovative, personalized, and integrated therapeutic approaches that address not only cutaneous lesions but also the functional and psychosocial aspects of the disease.