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Evaluating Functionality in Hand-Foot Atopic Dermatitis


Susan Taylor, MD, shared what she wants to know about patients' functionality to treat their atopic dermatitis with hand or foot involvement.

In the Dermatology Times Expert Perspectives series "Advancements in Atopic Dermatitis: Insights from the 2024 Masterclasses in Dermatology Conference," leading dermatologists discuss the advancements in treatments and data for atopic dermatitis (AD) with hand-foot involvement, diversity in clinical trials, and pearls from the American Academy of Dermatology's AD treatment guidelines.

Earlier this year, the US Food and Drug Administration approved an update to the label for dupilumab (Dupixent) in atopic dermatitis (AD), specifically addressing patients aged 12 years and older with uncontrolled moderate-to-severe hand and/or foot involvement.1 The label update is based on findings from the phase 3 LIBERTY-AD-HAFT trial, a double-blind, placebo-controlled study involving 133 adult and adolescent patients with AD and moderate-to-severe hand and/or foot involvement.2

This episode features insights from Susan Taylor, MD, professor of dermatology at the University of Pennsylvania Perelman School of Medicine in Philadelphia, on the importance of functionality when treating AD on the hands and feet.

Episode Transcript

Taylor: When I think about and evaluate my patients with hand-foot AD, the first thing I want to know is their level of functioning: Are they able to use their hands in every day? Activities? Can they grasp things? Can they close their hands? Remember, they're dry, they're tight, there are cracks. Also with feet, can patients walk and they walk long distances? Can they go upstairs? So there's severe impairment and quality of life and functioning and that's what I want to understand.

Until recently, quite often in terms of treatment goals. We want to restore, of course, the functioning of their hands. Just think about someone who does manual labor. They can't work they can't earn a living without their hands. And we have relied on barrier repair mechanisms, whether it's different moisturizers for example, topical medications like topical steroids. So that's what we have used in the past and relied on in the past this is a very exciting time in dermatology.

There are now new solutions for inflammatory diseases that we encounter every day. So about 7 years ago, when dupilumab came to market, it was a real game changer for my patients. And I'm very excited that they now have the indication for hand and feet AD. I think it will make a huge difference in the lives of many of our patients.

[Transcript edited for clarity]


1. Dupixent (dupilumab) U.S. label updated with data further supporting use in atopic dermatitis with moderate-to-severe hand and foot involvement. Regeneron. January 16, 2024. Accessed March 11, 2024. https://www.globenewswire.com/news-release/2024/01/16/2809695/0/en/Dupixent-dupilumab-U-S-Label-Updated-with-Data-Further-Supporting-Use-in-Atopic-Dermatitis-with-Moderate-to-Severe-Hand-and-Foot-Involvement.html

2. Simpson EL, Silverberg JI, Worm M, et al. Dupilumab treatment improves signs, symptoms, quality of life, and work productivity in patients with atopic hand and foot dermatitis: Results from a phase 3, randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2024 Feb 1:S0190-9622(24)00146-4. doi: 10.1016/j.jaad.2023.12.066. Epub ahead of print. PMID: 38296199.

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