62661 Dupilumab as a Therapeutic Approach for Keloids: A Review of Current Evidence

Document Type

Conference Proceeding

Publication Date

9-1-2025

Publication Title

J Am Acad Dermatol

Abstract

Keloids are pathologic fibro-proliferative scars. Current therapies treat individual lesions or limited body regions, such as corticosteroids, radiotherapy, and excision. Treatment can be challenging, especially in cases of disfiguring keloids or diffuse involvement. Dupilumab is a treatment approved for atopic dermatitis which blocks the IL-4/IL-13 signaling pathway. Dysregulation of transforming growth factor beta (TGF-β) is involved in the pathogenesis of keloids. IL-4 and IL-13 increase TGF-β, thus some postulate dupilumab may benefit keloids. Treatment of keloids with dupilumab, both systemic or lesional, have yielded variable results in the literature and in social media. We conducted a systematic review of treatment of keloids with dupilumab. Six studies with a total of 24 cases have been reported of patients treating keloids with dupilumab. 21% of cases (5/24) resulted in improvement (80% (4/5) had 600mg loading doses followed by 300mg every two weeks), cases 67% (16/24) resulted in no change (all had 300mg loading then 300mg), and 12% (3/24) showed worsening of lesions. For the single patient with concomitant atopic dermatitis (AD), their keloids improved. The two patients who had intralesional, rather than systemic, injections experienced non-improvement. Treatment plans of patients who had no change of keloids with dupilumab were characterized by lower dosages and shorter treatment duration (2 to 12 months). Dupilumab as a treatment for keloids is potentially promising, although studies comparing efficacy and optimization of systemic versus injected dupilumab and large-scale randomized control trials are needed.

Volume

93

First Page

AB176

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