Dupilumab as a novel therapy for eruptive lichen planus in an Asian patient with metabolic syndrome.

Lichen planus is an autoimmune inflammatory condition of unknown aetiology that affects the skin, nails and mucous membranes. There is currently a paucity of lichen planus treatment data in the Asian population. We present a case of an older Asian woman with metabolic syndrome and eruptive lichen planus that was successfully treated with dupilumab monotherapy. There is a plethora of clinical subtypes of lichen planus of which pruritus is a prominent symptom and can cause significant distress and reduction in quality of life. Metabolic syndrome is a prevalent health concern worldwide. It is a well--described entity of metabolic abnormalities, which include hypertension, central obesity, insulin resistance and dyslipidaemia. Metabolic syndrome is believed to play a significant role in the pathophysiology of chronic inflammatory dermatoses such as psoriasis and lichen planus due to the involvement of T helper 1 cytokines interleukin (IL)-2, IL-4, IL-6 and IL-10, and tumour necrosis factor-α in metabolic syndrome, which also contributes to the pathogenesis of lichen planus. The burden that this condition places on patients also poses challenges in terms of management options in individuals with metabolic syndrome. We describe the case of an older Asian woman with metabolic syndrome who developed sudden-onset extensive eruptive lichen planus and was successfully treated with dupilumab monotherapy.