Rotations 2.0 Episode 66 Contact Dermatitis

Episode 66 Contact Dermatitis

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Sport Rock by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 65  Eczema (Atopic Dermatitis)

Question 1 — Systemic Therapy Selection

A 32‑year‑old woman with moderate‑to‑severe atopic eczema has failed optimized topical corticosteroids, topical calcineurin inhibitors, and UVB therapy. She has no significant medical history and is not pregnant. She asks about the most evidence‑supported systemic therapy with the best long‑term safety profile and minimal laboratory monitoring. Which of the following is the most appropriate next‑line therapy?

C. Dupilumab 600 mg loading dose, then 300 mg every 2 weeks

Question 2 — Pediatric Treatment Decision

A 10‑year‑old boy (weight 28 kg) has severe atopic eczema poorly controlled with optimized topical therapy and narrow‑band UVB. His parents prefer a systemic option that is FDA/EMA‑approved for his age group and does not require routine blood monitoring. Which treatment is most appropriate?

B. Dupilumab 300 mg every 4 weeks

Question 3 — Contraindicated Therapy in Pregnancy

A 29‑year‑old woman with severe atopic eczema presents for follow‑up. She tells you she is 8 weeks pregnant and her disease is worsening despite appropriate topical corticosteroids and emollient therapy. Which of the following systemic therapies is contraindicated during pregnancy?

C. Upadacitinib

Paper for Next Week:

Bizjak, Mojca, Olivier Aerts, David Pesqué, Melba Muñoz, Riccardo Asero, Margarida Gonçalo, Thomas Rustemeyer, Mitja Košnik, Mark Kačar, An Goossens, Jose Hernán Alfonso, Charlotte G. Mortz, Maryam Ali Al‑Nesf, Joachim W. Fluhr, Howard I. Maibach, and Ana Maria Giménez‑Arnau. “Contact Urticaria and Related Conditions: Clinical Review.” Contact Dermatitis 93 (2025): 87–107.  

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